Biphasic pleural mesothelioma (BPM) is a subtype of malignant mesothelioma that accounts for approximately 20-30% of all mesothelioma cases. It is characterized by the presence of both epithelioid and sarcomatoid components within the tumor. The long-term effects of BPM depend on several factors, including the stage of the disease at diagnosis, the patient’s age and overall health, and the effectiveness of treatment.
Prognosis
BPM has a poorer prognosis compared to epithelioid mesothelioma, which is the most common subtype. The median survival time for patients with BPM is approximately 13 months from the time of diagnosis. However, some patients may survive for several years with appropriate treatment. The overall survival rates for BPM are lower compared to those for epithelioid mesothelioma, which has a median survival time of around 18-24 months.
Symptoms
The symptoms of BPM are similar to those of other types of mesothelioma and may include shortness of breath, chest pain, coughing, fatigue, weight loss, and night sweats. These symptoms may not appear until the disease has reached an advanced stage, making early detection and diagnosis important.
Diagnosis
The diagnosis of BPM typically involves a combination of imaging tests, such as CT scans and PET scans, and biopsy samples of the affected tissue. The biopsy samples are examined under a microscope to determine the subtype of mesothelioma and to confirm the diagnosis.
Treatment
The treatment options for BPM include surgery, chemotherapy, and radiation therapy. The choice of treatment depends on several factors, including the stage of the disease, the patient’s overall health, and the extent of the tumor. In some cases, a combination of treatments may be used.
Surgery
Surgery is often used to remove as much of the tumor as possible, although complete removal may not be possible in some cases. The type of surgery used depends on the location and size of the tumor. For BPM, a pleurectomy with decortication (P/D) or extrapleural pneumonectomy (EPP) may be used. P/D involves the removal of the affected tissue lining the lung and chest wall, while EPP involves the removal of the lung, diaphragm, and affected tissue lining the chest wall.
Chemotherapy
Chemotherapy involves the use of drugs to kill cancer cells. It may be used before or after surgery, or as a standalone treatment for patients who are not candidates for surgery. The most commonly used chemotherapy drugs for mesothelioma are cisplatin and pemetrexed.
Radiation Therapy
Radiation therapy involves the use of high-energy radiation to kill cancer cells. It may be used before or after surgery, or as a standalone treatment for patients who are not candidates for surgery. The most commonly used type of radiation therapy for mesothelioma is external beam radiation therapy.
Long-term effects of treatment
The long-term effects of treatment for BPM depend on several factors, including the type and extent of treatment, the patient’s age and overall health, and the stage of the disease at the time of treatment. Surgery, chemotherapy, and radiation therapy can all have side effects that may persist for several months or even years after treatment.
Surgery
The side effects of surgery for BPM may include pain, infection, bleeding, and difficulty breathing. In some cases, patients may experience a decrease in lung function following surgery, which can lead to shortness of breath and reduced physical activity.
Chemotherapy
The side effects of chemotherapy for BPM may include nausea, vomiting, hair loss, fatigue, and an increased risk of infection. Some chemotherapy drugs can also cause damage to the kidneys, liver, and nervous system.
Radiation Therapy
The side effects of radiation therapy for BPM may include fatigue, skin irritation, and inflammation of the esophagus, which can make it difficult to swallow. In some cases, radiation therapy can also cause damage to the lungs or heart.
Prognosis and Quality of Life
Despite advances in treatment, the long-term outlook for patients with BPM remains poor. However, some patients may survive for several years with appropriate treatment. The long-term effects of BPM on quality of life can be significant, as the disease can cause physical and emotional symptoms that can impact daily activities and overall well-being.
In conclusion, biphasic pleural mesothelioma is a rare and aggressive form of cancer that can have significant long-term effects on patients. The prognosis for BPM is generally poor, with a median survival time of approximately 13 months from the time of diagnosis. However, some patients may survive for several years with appropriate treatment. The long-term effects of treatment can also be significant, and patients may experience side effects that persist for several months or even years after treatment. Early detection and diagnosis are important for improving the chances of successful treatment, and ongoing research is needed to develop more effective therapies for this challenging disease.
