Epithelioid Mesothelioma

Quick Summary

Epithelioid mesothelioma (also called epithelial mesothelioma) is the most common of the three mesothelioma cell types, responsible for about 70% of all diagnoses. Epithelioid mesothelioma is often easier to treat than the other cell types. Patients with epithelial mesothelioma live for 12-24 months on average, and treatments are advancing all the time.

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What is Epithelioid Mesothelioma?

Epithelioid mesothelioma is the most common mesothelioma cell type. The American Society of Clinical Oncology (ASCO) notes that around 70% of all cases are epithelioid. The other cell types are sarcomatoid and biphasic.

All mesothelioma is caused by asbestos exposure. The epithelioid cells spread slower than other cell types, giving many epithelioid mesothelioma patients a better prognosis (overall health outlook).

Veterans have a high risk of this cancer as the U.S. military used asbestos until the early 1980s. Companies knew asbestos was harmful but hid the risks from the military and general public for decades to make money.

There is no cure for any mesothelioma cell type, but epithelioid mesothelioma is the easiest type to treat, so these patients often live longer.

The Mesothelioma Veterans Center can help you connect with top doctors treating epithelioid mesothelioma, file for VA benefits, and pursue financial aid. Learn more in our free veterans packet.

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Characteristics of Malignant Epithelial Mesothelioma Cells

Epithelioid CellsIllustration of cell type under microscope

Epithelial mesothelioma cells are shaped like ovals or cubes.

These cancer cells divide rapidly but stick to one another.

This prevents the cancer from spreading quickly and makes it easier to treat, according to the UPMC Hillman Cancer Center.

What Causes Epithelioid Mesothelioma?

All types of mesothelioma (including epithelial mesothelioma) are caused by asbestos.

If asbestos fibers are inhaled or swallowed, they can get stuck in the body for decades. Long-term irritation due to asbestos fibers can lead to cellular mutations and cancer tumors after 10-50 years.

Researchers don’t know why some patients develop epithelioid mesothelioma and others don’t.

Subtypes of Epithelioid Mesothelioma

Epithelial mesothelioma cells are broken down into various subtypes. Knowing these subtypes can help doctors avoid a misdiagnosis.

Subtypes of epithelial mesothelioma include:

  • Adenomatoid mesothelioma: Also called microglandular, it accounts for about 6% of all cases of malignant pleural mesothelioma. These cells look like cubes arranged in the shape of tiny glands.
  • Deciduoid mesothelioma: This type has round cells and is relatively rare. It could be mistaken for squamous lung cell cancer or large cell lymphoma.
  • Glandular mesothelioma: These cells are cube-shaped and usually found in the lungs. This cell type often looks like metastatic adenocarcinoma of the lungs.
  • Solid mesothelioma: This subtype can be classified as immature or, more commonly, mature. Mature cells form small nests or sheets. Immature cells are rounder and resemble lymphoma under a microscope.
  • Tubulopapillary mesothelioma: This common subtype has cube-shaped cells and looks like tiny tubules and usually don’t grow as quickly as other cancer cell types.

Well-differentiated papillary mesothelioma: This is a very rare subtype. Most cases are considered benign (noncancerous), and the cells spread slowly. A 2019 report noted that most cases are found in younger women with no history of asbestos exposure.

Epithelial Mesothelioma Symptoms

A doctor holds up a stethoscope to the chest of an older male patient
Epithelial mesothelioma symptoms should be checked by a mesothelioma doctor

Symptoms of mesothelioma do not vary widely by cell type. Instead, epithelial mesothelioma symptoms depend on where the cancer forms. Most mesothelioma cases develop in the lining of the lungs (pleura) or abdomen (peritoneum).

Symptoms of epithelial mesothelioma can include:

  • Chest pain and a cough
  • Loss of appetite
  • Lump on the chest wall beneath the skin
  • Nausea or vomiting
  • Pleural effusions (fluid buildup in lung lining)
  • Shortness of breath
  • Unexplained weight loss
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Epithelioid Mesothelioma Diagnosis

If doctors think a patient has epithelioid mesothelioma, they’ll first take note of their symptoms and then perform imaging tests to look for tumors in the body.

Common imaging tests include:

  • CT (computed tomography) scans
  • MRI (magnetic resonance imaging) scans
  • PET (positron emission tomography) scans
  • X-rays

After considering the symptoms and ordering an imaging test, a doctor will look at a patient's recent blood tests and consider recent physical exams. The doctor will also, most importantly, order a biopsy of a suspect tissue sample. A biopsy is the only way to confirm a mesothelioma diagnosis.

With a biopsy, doctors extract fluid or tissue samples from a possibly cancerous area and study them to see if cancer cells are present.

Epithelioid Mesothelioma Prognosis & Life Expectancy

Epithelial patients often have a better mesothelioma prognosis and longer life expectancy than sarcomatoid or biphasic patients. Though mesothelioma is deadly, the epithelial mesothelioma survival rate is higher than any other cell type.

According to the medical journal Human Pathology, epithelioid mesothelioma patients live for 12-24 months on average. Further, different treatments can improve survival times.

Epithelioid mesothelioma prognosis can improve through:

  • Chemotherapy — increased life expectancy to an average of 15.4 months
  • Surgery — increased life expectancy to an average of nearly 21 months
  • Multimodal Therapy — increased life expectancy to an average of 23.4 months

Researchers also continue to study how other treatments can help mesothelioma patients. Our qualified nursing staff can help you find the best treatment options. Call (877) 450-8973 to get started.

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Life Expectancy by Cell Type

Epithelioid mesothelioma is only one of the three cell types and has the best life expectancy of all three — biphasic, epithelial, and sarcomatoid.

  • Biphasic Mesothelioma — this cell type occurs when a tumor has both epithelioid and sarcomatoid cancer cells. It has a life expectancy of 10 months.
  • Epithelioid Mesothelioma — as discussed above, epithelial cells grow slowly compared to other types of mesothelioma cells and offer a life expectancy of between 12-24 months.
  • Sarcomatoid Mesothelioma — this cell type is the most aggressive. A sarcomatoid mesothelioma patient has a life expectancy of between 3.5 and 8 months.

Epithelioid Mesothelioma Treatment Options

Once a patient has been diagnosed with mesothelioma, they can work with doctors to create a treatment plan.

Common epithelial mesothelioma treatments include surgery, chemotherapy, and radiation.

Epithelioid Mesothelioma Surgery

Doctors may recommend mesothelioma surgery if there is no metastasis (i.e. the cancer hasn’t spread far) and the patient is otherwise healthy. Surgeries used to treat mesothelioma vary based on where the cancer formed.

Epithelioid mesothelioma surgeries include: 

Extrapleural pneumonectomy (EPP)
Extrapleural pneumonectomy (EPP) – this is a surgery commonly performed to treat pleural mesothelioma. Surgeons remove the lung nearest to the cancer tumors and surrounding infected tissue. This procedure can prevent recurrence (where the cancer comes back), improve quality of life, and extend the patient’s life.
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Pleurectomy with decortication (P/D)
Pleurectomy with decortication (P/D) – often considered as an alternative to EPP for patients in early stages of mesothelioma, P/D involves removing tumors from the lung lining rather than removing the lung entirely.
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Cytoreduction with HIPEC
Cytoreduction with HIPEC – this treatment is actually a combination of different procedures. First, abdominal surgery is done to remove all visible tumors from the peritoneum. Next, hyperthermic intraperitoneal chemotherapy (HIPEC) treatment is used to kill any remaining cancer.
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Epithelial mesothelioma usually responds better to chemotherapy than sarcomatoid mesothelioma does. A combination of pemetrexed and cisplatin or carboplatin is typically used to treat mesothelioma. Pleural epithelial mesothelioma patients treated with chemotherapy lived for 15.4 months on average, according to 2019 data from the Annals of Thoracic Surgery.

Radiation Therapy

Radiation therapy kills mesothelioma cells alongside surgery and/or chemotherapy.

Clinical Trials

Patients with mesothelioma may be eligible for clinical trials, which study emerging treatment options and new drug combinations.


Immunotherapy treatments help the immune system fight cancer. The Food and Drug Administration (FDA) approved the immunotherapy drugs Opdivo® and Yervoy® to treat mesothelioma in 2020.

Multimodal Therapy

A combination of treatments may be used in what is known as multimodal therapy. Epithelioid mesothelioma life expectancy increased to 23.4 months when patients received a combination of surgery, chemotherapy, and radiation, according to a 2019 study.

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Help for Epithelioid Mesothelioma Patients

Veterans make up 33% of all mesothelioma cases. Thankfully, the U.S. Department of Veterans Affairs (VA) offers many benefits to help veterans with mesothelioma and other asbestos-related diseases.

Through the VA, veterans can access:

  • Financial aid: Financial benefits typically award over $3,300 a month or more to veterans with mesothelioma.
  • Medical care: Some of the nation’s leading mesothelioma specialists treat veterans at VA hospitals in California and Massachusetts. Veterans with VA Health Care can access care from these doctors at little to no cost.
  • Help for family members: Loved ones can get survivor benefits and afford funeral costs with the VA’s help.

Veterans earned these benefits through their service to our country. If you're unsure what you or your family qualify for, fill out our form below so we can provide you with all the information you need to see how much compensation you qualify for.

Find Epithelioid Mesothelioma Treatment Near You

A diagnosis for epithelial mesothelioma — and the complications and symptoms of the disease itself — can feel overwhelming. It’s important to remember that there are a lot of options for help. Veterans are entitled to all the previously mentioned assistance among other benefits.

The Mesothelioma Veterans Center can help you access medical and financial VA benefits if you have mesothelioma. See what VA benefits are available for you right now.

Because veterans are so impacted by mesothelioma, VA hospitals are often great places to get treatment. Of course, veterans can also pursue medical care from non-VA mesothelioma hospitals if they wish. Chat with our team to learn about what resources are available to you or your loved one.

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FAQs About Epithelioid Mesothelioma

Is epithelioid mesothelioma always a type of malignant mesothelioma?

Epithelial mesothelioma is almost always a form of mesothelioma cancer.
It is not cancer of the epithelium (a tissue that covers major organs). Doctors refer to that type of cancer as carcinoma.
Patients with epithelial mesothelioma need medical treatment if they want to ease their symptoms and live longer. Epithelial malignant mesothelioma is a serious medical condition, but it is somewhat easier to treat than other cell types of mesothelioma.

What is the health outlook for epithelial mesothelioma patients?

The life expectancy for patients with epithelioid mesothelioma is between 12-24 months.
All forms of mesothelioma are aggressive and deadly. That said, patients with epithelioid mesothelioma may have a better outlook than those with sarcomatoid or biphasic mesothelioma.
Epithelial cells do not spread as quickly through the body as sarcomatoid cells, so they’re easier for doctors to treat.

How is epithelioid mesothelioma diagnosed?

Doctors diagnose epithelioid mesothelioma by examining a patient’s symptoms, then performing a biopsy to look for cancer cells under a microscope.

That said, epithelial mesothelioma can be hard to diagnose as the cells often resemble other types of cancers (such as lung cancer) under a microscope.

For this reason, pathologists may use immunohistochemical staining to confirm their diagnosis. Staining allows doctors to look for unique proteins that mean a patient might have cancer using special dyes.

Pathologists may use immunohistochemical stains to look for the protein calretinin, which is present in 95% of epithelioid mesothelioma cases.

Veterans Support Team
Todd Gersten, MD PhotoReviewed by:Todd Gersten, MD

Double Board-Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Todd Gersten, MD is a double board-certified medical oncologist and hematologist specializing in general adult oncology and hematologic disease. He is a physician partner with the Florida Cancer Specialists and practices in Wellington, Florida.

Dr. Todd Gersten is an independently paid medical reviewer.

Christopher Dryfoos PhotoWritten by:

Contributing Author

Christopher Dryfoos is a journalist and member of the American Medical Writers Association (AMWA). As the grandson of the U.S. Navy’s first forensic pathologist, he aims to help veterans with mesothelioma access needed care.

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