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Sarcomatoid Mesothelioma Treatment, Diagnosis Survival and Sub types

Sarcomatoid Mesothelioma- Do you know why Sarcomatoid mesothelioma happens to be one of the most dreaded forms of mesothelioma? Well, there are a number of reasons to explain this. But first, we would like to update you something more about this kind of mesothelioma cancer that you should know about it. 

sarcomatoid mesothelioma

We would also let you know about the line of treatment and  other diagnosis options that you have after your doctor confirms about it.Telling you in terms of numbers.

Please note that Sarcomatoid mesothelioma is a lesser known mesothelioma as it has the least known cell structure. Not only that, most patients have poor prognosis just because of the fact that this type of mesothelioma cancer progresses very fast and therefore becomes quite difficult to treat.

Telling you in the percentage of cases, please know that sarcomatoid mesothelioma is quite a rare type of mesothelioma that generally comprises only 10-20% of all mesothelioma cases. Furthermore, this kind of mesothelioma cancer has a limited number of treatment options and also quite a poor prognosis.

How Sarcomatoid Mesothelioma Cells are identified

After physicians’ receive a case of Sarcomatoid mesothelioma, they start using histology to first examine and confirm the cell type. In case, you are not aware what the term histology is all about, let's update you with that. Please note that histology happens to be the study of cells. The technique is used to examine the tumor cells and also to differentiate between healthy cells.

The biggest problem that comes forth in the line of diagnosis of sarcomatoid mesothelioma is that the cells look quite similar to the normal cell types and therefore most of the times; doctors are unable to recognize the cells. 

And this often affects the line of treatment as well. In spite of all these obstacles, there are a number of characteristics that made them different from their normal counterparts. Please take a look how sarcomatoid mesothelioma cells are different as compared to the normal cells:

  • ·      Spindle shape cells
  • ·      Large and elongated nucleus
  • ·      Occasionally have multiple nuclei
  • ·      Tendency to metastasize

As you can see above, most of the times, sarcomatoid mesothelioma cells not only look but also behave quite differently as compared to the normal cells. 

As we have updated you above, most of the time, you can see Sarcomatoid mesothelioma cells are mostly found to be separated from one another and behave just like spindle. That's the reason they can spread quickly across a number of distant locations in the body that is also termed as distant metastasis.

After a detailed examination of sarcomatoid cell types, it has been analyzed that they are categorized into its sub-types that includes transitional, lymphohistiocytoid and desmoplastic. 

Well, as the name suggests, all these sarcomatoid mesothelioma resides at different locations. And that is why they are called by these different names. Please take a look at each of the sarcomatoid mesothelioma cell type as per their names:

Transitional Mesothelioma

Please note that transitional mesothelioma generally resides at multiple locations including pleura (lining of lungs), pericardium (rare), peritoneum.

The cell patterns of such type of mesothelkioma become like spindle shape. Lastly, the metastasis type is defined as both local and distant.

Lymphohistiocytoid Mesothelioma

Now, take a look at yet another form of Sarcomatoid mesothelioma which is none other than Lymphohistiocytoid Mesothelioma. The location of this type of mesothelioma is around pleura and peritoneum.

Now, the cell pattern of this type of tumor largely varies from either being spindle shaped and polygonal. They can also be in the form of dense bundles of inflammatory immune cells as well.

The metastasis type of the above cell type is generally local. At the same time, it can also be distant and having the potential to reappear.

Desmoplastic Mesothelioma

Well, this happens to be this type of sarcomatoid mesothelioma that has been categorized as over the different cell type, metastasis and other crucial factors. 

Please note that the location of this kind of mesothelioma is pleura, peritoneum, tunica vaginalis and some other areas entirely made up of reproductive system.

The cells of this kind of mesothelioma do not follow a distinct pattern. Finally, the metastasis type is both local and distant along with its resemblance to none other than benign fibrous tissues.

Well, as you have enlisted as many as three sarcomatoid mesothelioma sub types, there is yet another sub-type that is known as heterologous mesothelioma. The basic feature of this sub-type is that it is loaded with sarcomatoid cells all over.

Now let's take you through some of the other characteristics of heterologous tumors that are very rarely found. And this pose a great challenge in the prognosis of this sub-type.

One of the main characteristics that sidelines heterologous tumor to other tumors happens to be the presence of cells from other body tissues that sometimes related to bone, soft tissue and cartilage.

These days, this has been quite a well known diagnostic criterion to check if any of the mesothelioma tumors has the presence of chondrosarcomatous or osteosarcomatous elements within the mass. This helps the physicians to determine the further line of treatment.

Pleural Mesothelioma- The Most Common Type of Mesothelioma

Do you know that pleural mesothelioma happens to be the most common type of lung cancer? Well, there are so many sub types of this type of disease that you would gradually know about, especially after you study them as per their cell shape and location.

Please take a look at both types of elements below:

Chondrosarcomatous elements: Largely have the presence of cartilage cells within the tumor.

Osteosarcomatous elements: Largely have the presence of bone cells within the tumor.

As Sarcomatoid mesothelioma is quite rare, the cells types are lesser known. And due to this, all its sub-types are often misdiagnosed. In case, if such a rare case is received, then physicians have no option but to undergo multiple biopsies, especially to make a confirmed diagnosis between mesothelioma and other tumors.

Sarcomatoid Mesothelioma Diagnosis

Please know that it is very important that proper diagnosis should be done for any type of mesothelioma tumor. But even before that, early detection is quite crucial before the progress of the treatment.

If you get the early detection, then almost half the battle is won. But it is not always possible to detect any such mesothelioma cancer so early. It's due to the fact that they grow very rapidly and before anything can be done, it becomes even harder to reach to the stage of treatment.

Now, as far as Sarcomatoid mesothelioma diagnosis is concerned, it is not easy to diagnose the tumor at an early stage mainly due to its long latency period. This causes the symptoms to emerge very late than expected.

How Malignant Sarcomatoid Mesothelioma is caused?

Most of the times, it has come to the notice that most patients who come with the symptoms of any type of mesothelioma, are affected with the long time exposure of asbestos. And this is where doctors get the signal of the main cause of the ailment.

Please note that airborne asbestos fibers can be easily inhaled or ingested that later get embedded in some other body organs. This is where the normal cells change into abnormal cells by undergoing sudden mutation of normal body cells into cancerous cells.

After the asbestos fibers are constantly inhaled for a period of time, they become the reason of organ inflammation and scarring of normal body cells.

Please note that long time asbestos exposure is known to be a well proven and tested reason that causes mesothelioma. Other than that, there are some other factors that can also become the rare cause of sarcomatoid mesothelioma to a certain extent.

Sarcomatoid Mesothelioma Symptoms

In this section, we are going to discuss about Sarcomatoid mesothelioma symptoms that can be many including fatigue, chest pain, abdominal pain, and nausea, difficulty in breathing, weight loss, fever and cough.

Common Diagnostic Tests for Mesothelioma

After the physicians manage to gather some of the vital information about mesothelioma patients, they start conducting a series of tests to get a confirmation that it is developing into a cancerous mass. The various tests that are involved include CT scan, PET Scan.

Sarcomatoid Mesothelioma Treatment

There are so many treatment options for the patients of mesothelioma that are the following:

  • Surgery
  • Chemotherepy
  • Radiation

Surgery- In general, it is a difficult task to remove tumor cells surgically.
Chemotherepy- Srcomatoid mesothelioma cells do not generally respond to the chemotherapy. Also, the above procedure is not so effective for the median survival of such patients.
Radiation- It sometimes used to make tumor cells shrink but is not overall as effective as it should be. Still, the radiation can help to surpass a few symptoms including pain and difficult breathing.

Please note that sarcomatoid mesothelioma generally does not respond well to the most conventional treatment as compared to epithelioid and biphasic mesothelioma. Here, the cells are busy to grow rapidly and reach to distant location or organ.

Further, there are a number of side effects that are attached with each line of treatment that only get worsen the symptoms with time.

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Can You Get Mesothelioma Without Asbestos Exposure

Can You Get Mesothelioma Without Asbestos Exposure- In this post, we would like to share various risk factors and causes of mesothelioma. Well, as you see, the ailment is quite tough to handle, it is better to prevent it from happening.

One thing you would require in order to prevent the dreaded disorder is by knowing its causes and risk factors. Doing this would help you move way ahead than others in knowing how to keep a tab on it.

Can You Get Mesothelioma Without Asbestos Exposure

As you are aware, asbestos exposure happens to be the prime factor responsible for spreading mesothelioma, there is a need to know more about the effects of asbestos in causing plural mesothelioma.

In order to ascertain if mesothelioma can spread even without asbestos exposure, you need to understand different types of asbestos exposures that actively take part in spreading the dreaded disorder.

Researchers are done in this regard to ascertain the effects of asbestos on different patients. It was only in 1892 when doctors were first able to ascertain the exact cause of plural mesothelioma.

They were able to do so after finding the tumor in the linings of lungs. This caused a lot of theories to generate explaining the real cause of spreading the ailment. Later, it was clearly established that mesothelioma is caused mainly due to the asbestos exposure.

Initially, a team of doctors studied the effects of asbestos in causing mesothelioma in as many as 33 patients. Later, it was established beyond doubt that this type of cancer is caused mainly after the exposure of asbestos.

On the other hand, asbestos industry continued to maintain that only certain types of asbestos cause mesothelioma. However, all researches maintained that all types of asbestos (including Chrysotile and Amphibole) are dangerous and can become the cause of cancer.

Different Types of Asbestos Exposure That Cause Pleural Mesothelioma

Hundreds of patients with plural mesothelioma (in the past) have reported a number of sources of asbestos exposure. Please take a look at some of the sources of asbestos that fall into these categories:

  • ·      Non Asbestos Industry- Construction Sites (Gypsum drywall factory)
  • ·      Military facilities- Fort Bragg, USS Alabama
  • ·      Asbestos Processing Plans-  WR Grace Vermiculite Plant, Jeffrey Asbestos Mine
  • ·      Shipyards- Hunters Point Naval Shipyard, Todd Shipyards
  • ·      Naturally Occurring Asbestos / Mines- California, Montana, Libby

If we try to analyse all the cases of asbestos exposure, then we come to the conclusion that almost all the exposures have occurred at industrial sites.

Until 1980's (when no major steps were taken to combat the asbestos exposure), asbestos continued to contaminate the official like power plants and refineries. And this caused a plethora of workers to cause long term exposure till the time they continued to work. This kind of slow and steady asbestos exposure becomes the most common reason to lead the disease.

Can You Get Mesothelioma Without Asbestos Exposure

As you see, the long term asbestos exposure has many ill-effects. Sometimes it may lead to more dreaded forms of the ailment like sarcomatoid mesothelioma. It's a rare form of mesothelioma and happens to be more aggressive to handle.

How Patients Get the Disorder Outside of Their Workplace

Well, it has been reported that patients have also been exposed to asbestos outside of their workplace. But this kind of exposure is far less frequent than the regular exposure levels.

You might be thinking where such kind of exposures are coming from? Well, we would like to tell you that these low range exposures generally arise from asbestos contaminated products that include loose-fill insulation, or the exposure coming from home on the skin or clothing, etc. All such asbestos exposure are categorized as secondary exposure or second-hand exposure.

Now, this is quite evident beyond doubt that low level asbestos exposure over a long period of time is sufficient to cause plural mesothelioma. In some of the cases, it has been noted that patients encounter the fibers in the natural environment.

Is There Any Minimal Levels of Asbestos Exposure that Gets Transformed Into Tumor?

Well, the duration and the level of asbestos exposure can very well affect the risk of developing the dreaded disorder. Even lower level of asbestos exposure can be harmful and may take the shape of plural mesothelioma.

As per the latest research done in this regard, there is no threshold value of the level of exposure ever recorded. So, nothing can be said on the minimal levels of asbestos exposure to get transformed into a tumor.

Can You Get Mesothelioma Without Asbestos Exposure

It's highly unlikely in most of the circumstances that you have the chance to get mesothelioma without coming in contact with asbestos.

In order to understand it properly, you need to know how it causes mesothelioma in the normal exposure of asbestos levels.  

It's only a rare occasion when patients without having a detailed history of asbestos exposure have transformed into plural mesothelioma. Please note that there are a few minerals that almost behave like asbestos, particularly in their structure.

They are often known by the term asbestiform minerals. These minerals behave in the same manner as asbestos and are known by the names Richterite and Winchite. Both these asbestos minerals are known to cause the lung tumor.

Other than the above, there are some other minerals that behave more or less in the same manner as asbestos and exist in the form of minerals like Zeolite or Taconite.

As per the latest research done in this regard, close to 80% of all plural mesothelioma cases are caused by the exposure of asbestos. There are some other ways responsible to cause the dreaded disorder like chemicals, radiation, some kind of inflammation and metals.

Among other reasons, radiation happens to be one of the ways that become the cause of a handful of mesothelioma cases.

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Sarcomatoid Mesothelioma symptoms, Diagnosis and Treatment

Sarcomatoid Mesothelioma- Before updating you with the term Sarcomatous mesothelioma, we would first like you to understand the term. The term is also known as Sarcomatoid plural mesothelioma which is actually the state of an advanced mesothelioma.

The main reason why it is one of the dreaded forms of lung tumor is due to the fact that it is formed by a lot of sarcomatoid cells located in the linings of lungs (plural membrane or pleura).

sarcomatoid mesothelioma

The fact that it is called as the least common type of mesothelioma can be evident by the fact that it can affect the line of treatment as well as prognosis.

We have already explained you above that this kind of mesothelioma is an advanced type which is characterized by sarcomatoid cells. As per the findings in this regard, it has been estimated that close to 20% such cases have the presence of sarcomatoid cells that have the capability to grow at an alarming rate.

More than that, these kind of cells are quite specialized ones that are quite resistant to the different treatment options as compared to the other mesothelioma cell types. And this pose somewhat high difficulty levels to control such kind of tumors in the long run.

How Sarcomatous Mesothelioma Looks Like

As the name relates, they are made up of Sarcomatoid cells and are also known by some other names like spindled, sarcomatous or diffused tumors that are known by another term as malignant fibrous mesothelioma.

In such kind of tumors, the cells are organized in an irregular way and take the shape of spindle with plump. They are also diffused with elongated nuclei.

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Most of the times, these specialized cells take the shape of sarcomatoid tumors and take less time making small nodules that starts scattering and growing along the surface of the lungs.
There are some rare forms of this kind of tumor where a single mass of tumor starts growing and most likely become harder to remove even after embarking surgeries, especially if it has started growing into the chest wall.

As you can relate yourself, a lot many complications arise after the growth of such tumors. And one such way it may create further complexity which is called plural diffusion. But this is not so common and is not found in the majority of such cases.

Talking about plural effusion, that happens to be the most common cause and symptom of initial mesothelioma that mostly accompany chest pain and shortness of breath. In most cases, these symptoms are not so much severe without the presence of plural effusion.

Other thing to be noted that most patients who have single mass of tumor growing in their chest wall complain more significant chest pain as compared to those who experience somewhat sheet like growth of tumor.

As you might know, all 3 kind of mesothelioma cell types- epithelial, sarcomatoid and biphasic is capable of affecting prognosis and treatment. In case, if a patient is diagnosed with sarcomatoid plural mesothelioma, a patient becomes more likely not to respond to the treatment.

sarcomatoid mesothelioma

This generally results in shorter and fewer treatment options and the survival rate also becomes lesser. However, if a patient develops such kind of growth at an early stage, he can have a lot more treatment options available that can be far more effective than above.

Diagnosis of Sarcomatous Mesothelioma

This kind of tumor is quite difficult to diagnose as they generally resemble benign and other kinds of malignant conditions.

Due to this, initial flaws are likely to happen and disrupt the route treatment along with their proper diagnosis. If you look their cells under microscope, you can see them growing just like other most common localized sarcoma tumors of the plural membrane.

Now, please take a look at some of the most common misdiagnoses for sarcomatous mesothelioma that generally include:

  • ·      Fibrous pleurisy
  • ·      Fibrosarcoma 
  • ·      Pleural liposarcoma
  • ·      Localized fibrous tumours
  • ·      Metastasized renal cell carcinoma

Best Practice to Test Sarcomatous Mesothelioma

As we have already covered that it is quite necessary to properly investigate this kind of mesothelioma which is possible only after conducting a series of vital tests.

The first step is to conduct an imaging test like an X-ray, MRI or CT scan. These tests basically help to identify the tumor visibly without undergoing any kind of hassles.

The next hurdle that comes forth is to identify the cell type. In order to make a correct diagnosis, a biopsy is done where a small mass of tumor is taken.

In general, biopsies are done to help physicians to better understand or closely examine the kind of tissue. In case, the sample tissue is too small, it becomes even harder to determine the type of cells associated in the tumor effectively. And this may lead to the initial misdiagnosis in assessing the kind of tumor.

Immunohistochemistry simply works with the help of antibodies that basically react with proteins in the sample tissue taken for biopsy.

This kind of test is quite simple and can see the result happening in a far less time. The technique is helpful as it helps in differentiating the tumor type that can readily help in determining the right line of treatment.

How Sarcomatous Mesothelioma Tissue Behave to the Stain Used in Immunohistochemistry

In general, the Sarcomatous mesothelioma tissue doesn't react to the antibody being used in this technique called Immuno-histo-chemistry. However, a plethora of antibodies like D2-40, CAM5.2, WT1 and podoplanin will simply mark the presence of sarcomatoid cells. In the same ways, these specific antibodies also stain negatively for other kind of tumors that look quite similar with the sarcomatoid tumours.

Why the Initial Diagnosis id Tough?

As you can see how the tumor containing sarcomatoid tissue behave to the stain used in the above technique, you can expect how difficult it is to properly diagnose the above anomaly.

The procedure of diagnosis also becomes hard due to the presence of as many as 3 variations of Sarcomatous mesothelioma that are desmoplastic, transitional and lymphohistiocytoid.

All three kind of variants are loaded with entirely different cell structures that make it tough to make a definitive and proper diagnosis.

Symptoms of Sarcomatous Mesothelioma

Now, take a look at the symptoms of Sarcomatous mesothelioma

Transitional Mesothelioma - Well, it's quite peculiar in shape by having spindle and plump shaped cells, instead of spindle shaped cells with plump along with elongated nuclei.

Desmoplastic Mesothelioma- This category happens to be one of the most difficult subtypes to diagnose. Also, it accounts to almost 5% of entire mesothelioma cases. The difficulty in diagnosing this kind of cell types is that it lacks a clear and defined pattern. These cell types also contain a plethora of elongated cells with collagen sheaths (bundles).

Lymphohistiocytoid Mesothelioma- These sub-types consist of even larger and spindle-shaped cells along with inflammatory and immune cells. These cells generally account for less than 1% of all such cases.

Effect of Sarcomatoid Cells Towards Prognosis and Treatment of Pleural Mesothelioma

As we have already explained you above about the kind of aggressiveness of sarcomatoid tumors to the different line of treatments, one thing that can be affirmed is that such kind of tumors hardly show response towards different treatment options.

However, the treatment basically revolves on the stage of mesothelioma along with its location. It simply means that physicians mainly go ahead with the conventional line of treatments that include chemotherapy, surgery and radiation therapy.

In case, the diagnosis is delayed, these sarcomatoid cells become even more resistant to the line of treatment.

How Sarcomatous Mesothelioma Response with Different Line of Treatments

Let’s analyse how the tumor generally response with all 3 lines of treatments.

Surgery- Well, these tumors are hard to be treated with surgery as they have a habit of penetrating to the chest wall. It becomes difficult to remove with surgery as they become more complicated.

Chemotherapy- It also have limitations towards treating the tumor.

Any Hope to Deal with Sarcomatous Mesothelioma?

There is a new drug Sodium Selenite that looks a potent chemotherapy drug suitable for all kinds of mesothelioma cell types.

As per the research done on this drug, it has been shown that it has the capacity to cause apoptosis (cell death), when combined with Doxorubicin (Anthracycline antibiotic). However, it has not been studied or practiced on humans till date.

As of now, clinical trials for such kind of mesothelioma looks hard due to its rare diagnosis. In order to deal with it, a plenty of specialized mesothelioma programs are being organised to improve the resources and treatment options for patients.

Before patients go for any kind of treatment, they should first consult mesothelioma specialist before deciding for the actual line of treatment.

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Top 2 Reasons of Development of Asbestos Cancer

Asbestos Cancer happens to be the most devastating form of lung cancer. But do you know how it develops and the probable causes responsible to spread the dreaded ailment? Well, let's give you some insights about this form of cancer before proceeding further.

Medical researches had already begun as early as 1935 to track down the most common causes related to the Asbestos cancer. After a series of extensive research, the factors responsible to spread this form of cancer was none other than asbestos exposure to your body. 

During the research, it was established by the National Cancer Institute that the level of asbestos exposure should be minimized to check the disorder under control. So, more will be the asbestos exposure to your body, lesser time it will take to spread the ailment.

In the year 1986, OSHA (Occupational Safety and Health Administration) confirmed without proclaiming any doubts that Americans who have to work with Asbestos are most prone to suffer Lung Cancer in the near future. So, Asbestos Cancer is going to be the greatest health hazard in America, if the level of asbestos exposure is not controlled.

What's Asbestos Cancer?

After throwing some light on the term, let's dig in more about the issues and causes responsible to spread the dreaded ailment.

Asbestos Lung cancer happens to be the rare form of cancer that has now become the prime cause of casualties in America. You will be surprised to know that as many as 5,000 deaths a year has been recorded due to asbestos cancer.

The figures look quite alarming and truly reflect almost 4% casualties happening due to lung cancer alone. The 90% of other deaths in America are linked to smoking.

Another crucial point that needs to be taken into account is the late diagnosis of lung cancer spreading due to the exposure of asbestos. This is due to the long latency period along with the development of onset of symptoms.

Before letting you know more about this form of lung cancer, let's make you understand with the term asbestos first. Well, asbestos is a naturally occurring mineral and can be easily found near your workplace, homes or the environment.

Asbestos has been in the use since 1880s due to a number of commercial purposes. Due to the extensive use of this mineral without proper protection, its use has been restricted. The mineral has even classified as a form of human carcinogen (cancer producing agent).

The mineral takes the form of carcinogen after it gets disturbed for commercial uses and then releases a kind of microscopic fiber to the environment. If these fibers are inhaled, they tend to get entrapped in the lungs.

If these fibers that you inhaled get unnoticed for a long period of time, they get accumulated in the lungs and actively involve causing serious inflammation and other related hazards. In certain cases, they even trigger the onset (development) of lung cancer.

Factors responsible to cause Asbestos Cancer

As per the research conducted in this regard, the key factors that affect the onset of the disease include-

  • Concentration of asbestos in your body
  • Duration of asbestos exposure to your body.

As per the Helsinki Criteria, the risk of development of lung cancer increases up to 4% with each year of its exposure. As per the findings of OSHA, the higher the asbestos exposure, the higher will be the risk of developing lung cancer.

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One more thing that needs to be understood is the implications of its exposure, which doesn't always look apparent as soon as it starts bulging. The fibers tend to get lodged in the linings of the lungs. The size of these fibers (3mm) has a tendency to get accumulated in the lining of lungs, whereas 5mm fibers tend to get lodged within the lung tissues.

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