Biphasic Mesothelioma

Biphasic mesothelioma occurs when a patient’s tumor consists of both types of mesothelioma cells: epithelioid and sarcomatoid. Biphasic mesothelioma tumors are easier to treat if more epithelioid cells are present. We can help biphasic mesothelioma patients better understand this cancer and access treatments needed to live longer.

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What Is Biphasic Mesothelioma?

Biphasic malignant mesothelioma is a type of cancer that contains both epithelioid (also known as epithelial) and sarcomatoid mesothelioma cells within the same tumor.

This cancer can develop in the lining of the lungs (pleura), abdomen (peritoneum), heart (pericardium), or testicles (tunica vaginalis) decades after asbestos exposure.

Quick Facts on Malignant Biphasic Mesothelioma

  • It is the second-most common mesothelioma cell type, accounting for about 20-30% of all cases according to the American Cancer Society (ACS).
  • Doctors may refer to it as mixed mesothelioma.
  • A mesothelioma tumor must include 10% of both epithelioid cells and sarcomatoid cells to be considered biphasic.
  • Biphasic patients have a better prognosis (health outlook) if there are more epithelial cells present, since they are easier to treat than sarcomatoid cells.
  • The life expectancy of biphasic mesothelioma is 10 months, but patients can sometimes become long-term survivors with top cancer treatments.

If you or a loved one has biphasic mesothelioma or any other type of this cancer, Lung Cancer Group may be able to help you.

Speak with our on-staff mesothelioma nurses now to learn about the best doctors and treatment options for your specific diagnosis.

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What Causes Biphasic Mesothelioma?

The only known cause of biphasic mesothelioma (and all other types of this cancer) is asbestos exposure.

If you or a loved one worked with or around asbestos products, you could have breathed in or swallowed asbestos fibers, which can damage your body and cause healthy cells to become cancerous.

“I got mesothelioma from working in the TV and movie studios with studio equipment like the lighting and the curtains. All those things had asbestos in them. And that’s how I ended up with asbestos in my body.”

— Jimmy, biphasic mesothelioma patient

Biphasic mesothelioma tumors contain both types of mesothelioma cells: epithelioid and sarcomatoid.

All types of mesothelioma develop 10-50 years or more after asbestos exposure. Doctors currently don’t understand what causes patients to develop one specific mesothelioma cell type over another.

Symptoms of Mesothelioma Biphasic Tumors

You may experience different biphasic mesothelioma symptoms depending on the location of the tumor. Most cases of biphasic mesothelioma affect either the pleura or peritoneum, with each having unique symptoms.

Biphasic pleural mesothelioma symptomsBiphasic peritoneal mesothelioma symptoms
Chest painAbdominal pain
A cough that won’t go awayBloating or swelling of abdomen
Pleural effusion (fluid buildup in lung lining)Ascites (fluid buildup in abdomen)
Shortness of breathChanges in bowel movements (diarrhea/constipation)
Strange lumps under the skin of chestNausea
Unexplained weight lossWeight loss and lack of appetite

Symptoms of biphasic mesothelioma can take decades to appear after asbestos exposure. Overall health, age, and pre-existing conditions can also influence your symptoms.

Call (877) 446-5767 for help connecting with top doctors and treatments if you have possible symptoms of biphasic mesothelioma.

How to Diagnose Biphasic Mesothelioma

If doctors suspect you may have biphasic mesothelioma cancer, they’ll use several different tests to help make a diagnosis.

Steps to diagnose biphasic mesothelioma include:

  1. Basic health exam: Here, doctors will assess your symptoms. Make sure to tell your doctor if you or a loved one was ever exposed to asbestos, as this can help them make a diagnosis.
  2. Imaging scans: Doctors use imaging scans like X-rays and CT scans to look inside your body to find the possible cause of your symptoms.
  3. Biopsy: If doctors see potentially cancerous tumors on imaging scans, they can order a biopsy. A biopsy involves removing a tissue or fluid sample so a pathologist (doctor who studies cells) can review it. This is the only way to confirm a mesothelioma diagnosis.

If pathologists see both epithelial and sarcomatoid cells on the biopsy, you have a biphasic tumor.

Preventing Mesothelioma Misdiagnosis

Since biphasic mesothelioma is so rare, doctors must use great care to avoid misdiagnosing you with the wrong cell type, a different cancer, or other health problems.

Steps doctors can take to prevent misdiagnosis include:

  • Follow-up biopsies: A single biopsy may only show epithelioid or sarcomatoid cells, depending on which cell type is dominant. Getting an additional biopsy using techniques like a thoracoscopy (camera-assisted removal of tissue) can ensure your diagnosis is accurate.
  • Immunostaining: A 2022 report published in Histopathology noted that immunohistochemistry staining (immunostaining) can distinguish biphasic mesothelioma from non-small cell lung cancer (NSCLC) and other cancers. Immunostaining allows doctors to detect specific antigens (substances like proteins) that are unique to mesothelioma cells.

If you believe you’ve been misdiagnosed, promptly speak with your oncologist (cancer doctor) about your concerns.

Biphasic Mesothelioma Prognosis

The mesothelioma prognosis for biphasic tumors depends on the ratio of epithelial to sarcomatoid cells. If there are more epithelioid cells, your cancer could be easier to treat, allowing you to potentially live longer.

Here are biphasic mesothelioma prognostic statistics:

  • The average mesothelioma life expectancy for biphasic patients is 10 months, according to a report published in F1000 Research. However, you could potentially live longer with the right care plan.
  • The 1-year biphasic mesothelioma survival rate is 43%, as noted by a Journal of Thoracic and Cardiovascular Surgery report. This means 43% of patients were still alive a year after their diagnosis.

Factors like your overall health, age, and cancer stage also affect prognosis. Your initial biphasic mesothelioma prognosis could also change over time depending on how your body responds to cancer treatments.

Connect with our mesothelioma nurses now for help finding ways to improve your biphasic mesothelioma prognosis.

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Treatment for Mesothelioma Biphasic Type

Doctors can use a wide range of treatments, like surgery, chemotherapy, and immunotherapy, to help you live longer with biphasic mesothelioma.

Learn about common biphasic mesothelioma treatments and which ones may work best for your case below.

Biphasic Mesothelioma Surgery

Mesothelioma surgery allows doctors to remove cancerous biphasic tumors and tissue. Different surgeries may be used depending on where the cancer develops in the body.

Surgical procedures include:

  • Cytoreduction with HIPEC: Used to treat biphasic peritoneal mesothelioma by surgically extracting cancer from the abdominal lining, then bathing the surgery site with heated chemotherapy. A 2023 case study from the International Journal of Surgery Case Reports reported on a biphasic peritoneal mesothelioma patient who was still cancer-free 5 years after receiving this treatment.
  • Extrapleural pneumonectomy (EPP): Removes the diseased lung, part of the diaphragm, and the lung lining in cases of biphasic pleural mesothelioma. Biphasic patients lived for 10 months on average when treated with an EPP and follow-up radiation, as noted in a Journal of Thoracic and Cardiovascular Surgery report.
  • Pleurectomy with decortication (P/D): Also used to treat biphasic pleural mesothelioma, this surgery removes cancer tumors and the lung lining while sparing the lung. Biphasic patients lived for nearly 17 months on average with this surgery, according to a study published in 2022 by the Journal of Thoracic and Cardiovascular Surgery.

Doctors typically recommend using surgery for biphasic mesothelioma if the cancer responds to chemotherapy and other systemic treatments (which circulate through the body to kill cancer).

Chemotherapy

Chemotherapy involves the use of anti-cancer drugs like cisplatin and pemetrexed to destroy rapidly growing mesothelioma cells.

In a 2023 review of statistics from the National Cancer Database (NCDB), biphasic pleural mesothelioma patients lived for roughly 1 year on average when treated with chemotherapy. The 3-year survival rate for these patients was 17%.

Immunotherapy

Immunotherapy uses drugs like Opdivo® (nivolumab) and Yervoy® (ipilimumab) to boost the immune system’s ability to fight cancer.

“Immunotherapy is much more effective for the biphasic and certainly the sarcomatoid subtype.”

— Dr. Joseph Freidberg, mesothelioma specialist at Temple University Health System

The survival times of pleural biphasic mesothelioma patients increase to at least 18 months on average when immunotherapy and chemotherapy are combined.

Call (877) 446-5767 to learn if immunotherapy or other treatments could help you after a biphasic mesothelioma diagnosis.

Radiation

Radiation therapy uses beams of energy to treat biphasic mesothelioma tumors and prevent their spread. The 2023 NCDB review found that biphasic mesothelioma patients lived for a little over 9 months on average when radiation was the only treatment used.

Radiation may be more effective as part of a multimodal treatment plan, where several therapies are combined for best results.

Palliative Treatments

Palliative care focuses on relieving symptoms and improving the quality of life. Less aggressive chemotherapy and surgeries can help manage pain, slow tumor growth, and improve breathing for biphasic patients.

Emerging Treatments

New treatments for biphasic mesothelioma are continually being developed in clinical trials across the country. The hope is to find better ways to help patients live longer.

For example, ADI-PEG 20 (pegylated arginine deiminase), an enzyme being studied as a cancer treatment, looks promising in improving survival for sarcomatoid and biphasic mesothelioma patients.

When combined with chemotherapy, ADI-PEG 20 quadrupled three-year survival rates for these patients, according to the results of a 2024 trial published in JAMA Oncology.

Speak with our registered nurses to find the best treatments for biphasic mesothelioma.

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Amy Fair
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Compensation Options for Biphasic Mesothelioma

If you or someone you love is facing a biphasic mesothelioma diagnosis, you may be able to seek compensation to cover medical expenses and keep your family financially secure.

Compensation sources include:

  • Asbestos trust funds: These trusts contain over $30 billion today. By filing trust fund claims, you can pursue your share of this compensation without going to court.
  • Mesothelioma lawsuits: Lawsuits for mesothelioma typically award over $1 million on average, and you may start to get compensation in 90 days or less.
  • VA benefits: If you’re a U.S. veteran with mesothelioma, you may qualify for benefits from the U.S. Department of Veterans Affairs (VA), including monthly compensation and free or low-cost health care.

Lung Cancer Group has partnered with skilled mesothelioma lawyers. If you qualify, these lawyers can file lawsuits, trust fund claims, and VA benefits claims on your behalf and fight for maximum compensation.

“All of a sudden one settlement check showed up and then another check showed up, and then another, and they are still coming in now. It’s been very satisfying. I know that my wife is going to be taken care of for the rest of her life, after I’m gone.”

— Jimmy, biphasic mesothelioma patient

Contact us now for help seeking compensation for biphasic mesothelioma. Our legal partners may be able to assist you right now.

Find Help After a Biphasic Mesothelioma Diagnosis

At Lung Cancer Group, we’re dedicated to helping lung cancer and mesothelioma patients and their loved ones navigate their treatment options and secure financial support.

If you or someone you love has been diagnosed with biphasic mesothelioma — or any other type of this cancer — our team may be able to assist you.

We can connect you with:

  • Mesothelioma nurses who can help you understand your treatment options
  • Lawyers who typically secure $1 million+ for patients
  • Top mesothelioma doctors near you
  • VA-accredited agents to help U.S. veterans get military benefits

Call (877) 446-5767 to discuss your situation and get the help you need.

Biphasic Mesothelioma FAQs

What is a biphasic mesothelioma histology?

Histology is the study of cells and tissues. When a patient has a biphasic mesothelioma histology, it means that their cancer tumors contain both epithelioid cells (which are easier to treat) and sarcomatoid cells (which are very aggressive).

A patient’s overall health outlook depends on if more epithelioid cells are present.

The 1-year survival rate for biphasic mesothelioma is 43%, with some patients living much longer. In certain cases, patients with biphasic mesothelioma have lived for 5 years or more thanks to the right medical treatments.

Connect with our registered mesothelioma nurses now to find treatments that could improve your survival rate.

Biphasic mesothelioma cancer tumors contain epithelioid cells and sarcomatoid cells. In cases of epithelioid mesothelioma, only epithelial cells are present.

Because sarcomatoid mesothelioma is more aggressive and spreads faster than epithelioid, biphasic patients typically have a poorer prognosis than those with pure epithelioid tumors.

Still, treatments are available to help patients possibly live longer, no matter which cell type they have.

There are three main surgeries for biphasic mesothelioma:

  • Cytoreduction with HIPEC, which combines heated chemotherapy and surgery to treat biphasic peritoneal mesothelioma.
  • Extrapleural pneumonectomy (EPP), which removes cancer tumors, the lung and lung lining closest to the cancer, and other diseased organs in biphasic pleural mesothelioma.
  • Pleurectomy with decortication (P/D), which is also used to treat pleural mesothelioma by extracting cancer tumors and the lung lining but leaving both lungs intact.

All of these surgeries could possibly help you or a loved one with biphasic mesothelioma live longer. Doctors typically recommend biphasic mesothelioma surgery if the cancer responds to other treatments like chemotherapy first.

Lung Cancer Group was established by a team of caring advocates so those with lung cancer and other asbestos-related diseases can get the help they deserve. Our site provides the most accurate and up-to-date information about lung cancer, its link to asbestos, and financial compensation available to patients. Contact us to learn more and get assistance.

  1. American Cancer Society. (2018, November 16). Retrieved July 26, 2024, from https://www.cancer.org/cancer/types/malignant-mesothelioma/about/malignant-mesothelioma.html
    Amin, W., et al. (2019, June 3). Factors influencing malignant mesothelioma survival: a retrospective review of the
  2. National Mesothelioma Virtual Bank cohort. Retrieved July 26, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198263/
  3. Bou-Samra, P., et al. (2023, April 16). Epidemiological, therapeutic, and survival trends in malignant pleural mesothelioma: A review of the National Cancer Database. Retrieved July 26, 2024, from https://onlinelibrary.wiley.com/doi/10.1002/cam4.5915
  4. Brcic, L., et al. (June 2020). Clinical significance of histologic subtyping of malignant pleural mesothelioma. Retrieved July 26, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354152/
  5. Brosseau, S. (2019, May 13). Shorter Survival in Malignant Pleural Mesothelioma Patients With High PD-L1 Expression Associated With Sarcomatoid or Biphasic Histology Subtype: A Series of 214 Cases From the Bio-MAPS Cohort. Retrieved July 26, 2024, from https://pubmed.ncbi.nlm.nih.gov/31279641/
  6. Cancer Research UK (2023, May 17). Types and grades of mesothelioma. Retrieved July 26, 2024, from https://www.cancerresearchuk.org/about-cancer/mesothelioma/types-grades
  7. Cedres, S., et al. (November 2021). Efficacy of chemotherapy for malignant pleural mesothelioma according to histology in a real-world cohort. Retrieved July 26, 2024, from https://pubmed.ncbi.nlm.nih.gov/34725384/
  8. Churg, A., et al. (2022, August 25). Hypothesis: HEG1 and claudin-4 staining will allow a diagnosis of epithelioid and biphasic mesothelioma versus non-small-cell lung carcinoma with only two stains in most cases. Retrieved July 26, 2024, from https://onlinelibrary.wiley.com/doi/abs/10.1111/his.14783
  9. Kim, S., et al. (2018, September 29). Is There a Role for Cancer-Directed Surgery in Early-Stage Sarcomatoid or Biphasic Mesothelioma? Retrieved July 26, 2024, from https://www.annalsthoracicsurgery.org/article/S0003-4975(18)31335-3/fulltext
  10. Lapidot, M., et al. (November 2022). Outcomes of pleurectomy decortication in patients with biphasic mesothelioma. Retrieved July 26, 2024, from https://www.sciencedirect.com/science/article/abs/pii/S0022522322003592
  11. Lococo, F., et al. (April 2020). Survival results in biphasic malignant pleural mesothelioma patients: A multicentric analysis. Retrieved July 26, 2024, from https://www.sciencedirect.com/science/article/pii/S0022522319317519
  12. Perrot, M. et al. (February 2016). Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma. Retrieved July 26, 2024, from https://www.sciencedirect.com/science/article/pii/S0022522315019868
  13. Salle, F.G., et al. (August 2018). New Insights on Diagnostic Reproducibility of Biphasic Mesotheliomas: A Multi-Institutional Evaluation by the International Mesothelioma Panel From the MESOPATH Reference Center. Retrieved July 26, 2024, from https://pubmed.ncbi.nlm.nih.gov/29723687/
  14. Sugarbaker, P. (June 2023). Response to Nivolumab followed by complete cytoreductive surgery with HIPEC resulted in long-term survival in a patient with sarcomatoid-predominant biphasic peritoneal mesothelioma. A case report. Retrieved July 26, 2024, from https://www.sciencedirect.com/science/article/pii/S2210261223004881
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