Epithelioid Mesothelioma

Epithelioid mesothelioma (also called epithelial mesothelioma) is the most common of three mesothelioma cell types. It is also the easiest cell type to treat, so patients might live longer. The Mesothelioma Veterans Center helps U.S. veterans with epithelioid mesothelioma access treatments, military benefits, and financial aid — see how below.

Get a Free Veterans Packet

What Is Epithelioid Mesothelioma?

Epithelioid mesothelioma is the name for mutated oval or cube-shaped cells found in most cases of this cancer.

Epithelioid Mesothelioma Quick Facts

  • About 70% of mesothelioma patients have epithelioid mesothelioma, according to the American Society of Clinical Oncology (ASCO).
  • Epithelioid mesothelioma cancer cells divide rapidly but stick to one another.
  • It is easier to treat than other mesothelioma cell types, according to the UPMC Hillman Cancer Center.

People with this cell type may be able to live for nearly 3 years on average, or longer, if they get treatment.

Epithelioid Cells
Epithelioid Mesothelioma Life Expectancy with Treatment
28
30
32
34
36
38
40
~3 Years
[life expectancy in months]

The Mesothelioma Veterans Center can help veterans and families affected by epithelial mesothelioma access top treatments, VA benefits, and compensation.

Get started with our Free Veterans Packet — tailored exclusively to help veterans with mesothelioma and their loved ones.

Mesothelioma Veterans Guide
Get a FREE Veterans Packet

Get information on:

  • Top Treatments
  • Best Doctors
  • Improving Prognosis

Get a Free Veterans Packet

What Causes Epithelioid Mesothelioma?

Malignant epithelioid mesothelioma and all other types of this cancer are caused by asbestos exposure.

Anyone working with asbestos products may have been exposed to the microscopic fibers. They could have breathed in or swallowed the fibers, which would have gotten stuck in the body, causing long-term irritation.

Healthy cells in the body can mutate into mesothelioma cells 10-50 years after exposure.

U.S. veterans have a high risk of this cancer as the U.S. military used many asbestos-containing products until the early 1980s.

Symptoms of Epithelioid Mesothelioma

A doctor holds up a stethoscope to the chest of an older male patient

Epithelial mesothelioma symptoms 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

See a mesothelioma doctor if you have any mesothelioma symptoms and were exposed to asbestos during your military service or at a job.

We can help you find top doctors who can diagnose epithelial mesothelioma. Contact us now to get started.

Epithelioid Mesothelioma Diagnosis

Epithelioid Cells

To diagnose epithelioid mesothelioma, your doctors will conduct a physical exam and take note of any symptoms you have. They’ll then order imaging tests to look for tumors in your body.

Imaging tests used to diagnose mesothelioma include:

  • CT (computed tomography) scans
  • MRI (magnetic resonance imaging) scans
  • PET (positron emission tomography) scans
  • X-rays
Epithelioid CellsEpithelioid CellsIllustration of cell type under microscope

If doctors find signs of cancer on these scans, they’ll order a biopsy. A biopsy allows them to remove a fluid or tissue sample and review it under a microscope.

This test must be used to confirm a mesothelioma diagnosis, as it’s the only way doctors can see if epithelial cells are present.

Epithelioid Mesothelioma Prognosis

Epithelial patients often have a better prognosis (health outlook) and live longer than patients with the two other cell types — sarcomatoid or biphasic mesothelioma cells.

Prognosis is measured using life expectancy and survival rate. Find prognosis data for epithelioid mesothelioma below.

What Is the Epithelioid Mesothelioma Life Expectancy?

Life expectancy is how long a person typically lives after a diagnosis.

Did you know?

According to recent studies, the life expectancy for mesothelioma patients with this cell type is nearly 3 years with treatment, and some patients live longer.

The Mesothelioma Veterans Center team can help you find treatments to improve your mesothelioma life expectancy. Learn more in our Free Veterans Packet.

Mesothelioma Veterans Guide
Get a FREE Veterans Packet

Get information on:

  • Top Treatments
  • Best Doctors
  • Improving Prognosis

Get a Free Veterans Packet

What Is the Survival Rate of Epithelioid Mesothelioma?

Survival rate is the percentage of patients still alive a certain number of years after diagnosis. Texas Oncology reports that the 2-year epithelial mesothelioma survival rate is 65% and the 5-year survival rate is 27% with treatment.

These survival rates are much higher than those of the other types of cells. For example, the 2-year survival rate for sarcomatoid mesothelioma is 20%.

Epithelioid Mesothelioma Treatment Options

Common epithelial mesothelioma treatments used to help patients live longer include surgery, chemotherapy, and radiation. Patients should work with their mesothelioma doctors to find the best treatments for their case.

Learn about mesothelioma treatments below.

Epithelioid Mesothelioma Surgery

Doctors may use mesothelioma surgery to remove tumors if there is no metastasis (cancer spread through the body). Surgeries used to treat mesothelioma vary based on where the cancer formed.

Epithelioid mesothelioma surgeries include: 

  • Extrapleural pneumonectomy (EPP): Used to treat pleural mesothelioma (which forms in the lung lining) by removing the tumors, the lung closest to the cancer, and the lining of the lungs. Epithelial patients who underwent an EPP had an average life expectancy of 22 months, according to a Translational Lung Cancer Research report published in 2022.
  • Pleurectomy with decortication (P/D): Also used to treat pleural mesothelioma, but only the lung lining and cancer are removed (both lungs stay intact). Epithelial patients who received a P/D and heated chemotherapy lived for over 38 months on average in the 2022 study mentioned above.
  • Cytoreduction with HIPEC: Used to treat peritoneal mesothelioma (which forms in the abdominal lining) by removing cancer tumors from the lining and then applying heated chemotherapy. In a 2022 study of epithelioid patients who received this treatment, the 5-year survival rate was 42% and the average life expectancy was 38.4 months.

Our on-staff mesothelioma nurses can help you find the best treatments for your case. Call (877) 450-8973 to get started.

Chemotherapy

Chemotherapy (cancer-killing drugs) is often used as part of an epithelioid mesothelioma treatment plan. A combination of chemo drugs like pemetrexed and cisplatin or carboplatin can help destroy epithelioid mesothelioma cells.

Epithelial pleural mesothelioma patients treated with only chemotherapy lived for 15.8 months on average, according to 2022 data from Translational Lung Cancer Research. When patients receive chemotherapy alongside other treatments, they may live even longer.

Radiation Therapy

Radiation therapy uses beams of energy to kill epithelioid mesothelioma cells.

In a 2021 Communications Biology study, radiation was used before surgery to help treat pleural epithelioid mesothelioma. Patients who received this treatment combination lived for 36 months on average.

Immunotherapy

Immunotherapy treatments help the immune system fight cancer.

According to 2020 data from the U.S. Food and Drug Administration (FDA), immunotherapy helped pleural epithelial mesothelioma patients live nearly three months longer on average compared to patients who only received chemotherapy.

Multimodal Therapy

Combining different treatment options in what’s known as multimodal therapy may help epithelioid patients live longer.

For example, women with pleural epithelial mesothelioma who received an EPP, radiation, and chemotherapy in a multimodal treatment plan lived for 70 months (nearly 6 years) on average, according to a 2020 Journal of Thoracic Oncology study.

Find the best treatments for epithelioid mesothelioma with our help. Learn how in our Free Veterans Packet.

Mesothelioma Veterans Guide
Get a FREE Veterans Packet

Get information on:

  • Top Treatments
  • Best Doctors
  • Improving Prognosis

Get a Free Veterans Packet

Clinical Trials

Epithelial mesothelioma patients may qualify for clinical trials, which study emerging treatment options and new drug combinations.

For example, a study starting in September 2023 will test different combinations of chemotherapy and immunotherapy to see how they can help patients with epithelioid pleural mesothelioma (as well as patients with other cell types).

Palliative Care

Palliative care focuses on easing a patient’s pain and symptoms. Different palliative treatments can help epithelioid mesothelioma patients.

For example, a catheter or talc pleurodesis (sealing the pleura with talcum powder) can be used to manage fluid buildup.

“Since my talc pleurodesis procedure was carried out, I have improved health-wise and my breathing has also improved almost back to normal.”

— Pleural epithelioid mesothelioma patient

Subtypes of Epithelioid Mesothelioma

There are several subtypes of epithelial mesothelioma, most of which are quite rare. Some subtypes are easier to treat than others, which can affect a patient’s prognosis.

Epithelioid mesothelioma cell subtypes include:

  • Adenomatoid mesothelioma: This accounts for about 5% of all cases of malignant pleural mesothelioma. Though rare, doctors can recommend treatments.
  • Cystic mesothelioma: This type is usually found in cases of peritoneal mesothelioma that affect women. Cystic mesothelioma is usually benign (not cancerous).
  • Deciduoid mesothelioma: Fewer than 5% of patients have deciduoid mesothelioma, according to a 2022 study. Patients with this subtype have a poor health outlook, but treatments may still help.
  • Solid mesothelioma: This subtype can form in nest or sheet-like patterns. A 2020 Histopathology study found that patients with solid mesothelioma had an average survival time of a little over 1 year.
  • Tubulopapillary mesothelioma: This common subtype has cube-shaped cells and grows slower than the other cancer cell types. Patients with this subtype lived for nearly 2 years on average in a 2020 Histopathology study.
  • Well-differentiated papillary mesothelioma: This is a very rare subtype. Most cases are considered benign, and the cells spread slowly. However, a 2019 Modern Pathology report found that some cases could be cancerous.

A mesothelioma specialist can determine if you have an epithelial mesothelioma subtype when reviewing a biopsy under a microscope.

Get Help for Epithelioid Mesothelioma

The Mesothelioma Veterans Center has helped veterans, civilians, and families with epithelial mesothelioma get medical treatments, VA benefits, and financial aid.

Here are next steps we suggest if you have epithelioid mesothelioma:

  1. Get our Free Veterans Packet: This packet helps veterans and their families understand what their medical and financial options are after an epithelioid diagnosis.
  2. Find treatments: Work with the Mesothelioma Veterans Center’s caring and dedicated nurses to find the best doctors and treatments for your case.
  3. File or increase VA benefits: We have VA-accredited agents on staff who can help you file for mesothelioma VA benefits worth almost $4,000 a month in many cases. We can also help increase your monthly payouts if you already have benefits.
  4. Get additional compensation: Besides VA benefits, you may be able to file private claims to receive more compensation to cover medical bills and protect your family.

We recently secured $8.26 million for an epithelial mesothelioma patient and millions could be available to you too.

Contact the Mesothelioma Veterans Center now to get help for mesothelioma.

Epithelioid Mesothelioma FAQs

Is epithelioid mesothelioma curable?

There is no official cure for epithelioid mesothelioma yet, but epithelial patients might live for many years depending on the treatments they receive.

Surgery, chemotherapy, and other treatments can all help improve life expectancy. Call (877) 450-8973 to get help finding treatments for mesothelioma.

What are the stages of epithelioid mesothelioma?

There are four stages of epithelioid pleural mesothelioma.

Stage 1 is the least advanced and most treatable, while stage 4 is the most advanced as the cancer has spread through the body.

There are treatments available for patients in every stage, allowing patients to ease their pain and possibly live for many years.

Cases of mesothelioma that affect other body parts (such as peritoneal mesothelioma) don’t have official stages.

Instead, doctors will see how far the tumors have spread when making a diagnosis and recommend treatments.

What is the health outlook for epithelial mesothelioma patients?

The health outlook or prognosis for epithelioid mesothelioma is better when compared to the other cell types.

Many epithelioid patients live for nearly 40 months (over 3 years) with aggressive treatments — while the other mesothelioma cell types can kill patients in just months.

Epithelial cells do not spread as quickly through the body as sarcomatoid cells, for example, so they’re easier for doctors to treat.

Can immunohistochemistry help diagnose epithelial mesothelioma?

Yes. Cancer pathologists (who study cell and tissue samples) may use immunohistochemical staining to confirm an epithelial diagnosis.

Epithelial cells may look like those of other cancers (such as adenocarcinoma of the lungs or lymphoma) under a microscope.

Staining allows doctors to look for the protein calretinin, which is present in 95% of epithelioid cases. Getting stains can prevent patients from being misdiagnosed.

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.

  1. Acs, M., et al. (2023, June 22). Ten-year single-center experience with treatment of primary diffuse malignant peritoneal mesothelioma (DMPM) by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Retrieved March 11, 2024, from https://link.springer.com/article/10.1007/s00423-022-02594-6.
  2. American Society of Clinical Oncology. (2020, September). Mesothelioma - Introduction. Retrieved March 11, 2024, from https://www.cancer.net/cancer-types/mesothelioma/introduction.
  3. Bilecz, A., et al. (2020, March 14). Comparative analysis of prognostic histopathologic parameters in subtypes of epithelioid pleural mesothelioma. Retrieved March 11, 2024, from https://onlinelibrary.wiley.com/doi/full/10.1111/his.14105.
  4. Blanquart, C., Jaurand, M., & Jean, D. (2020, March 25). The biology of malignant mesothelioma and the relevance of preclinical models. Retrieved March 11, 2024, from https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.00388/full.
  5. Chan, M., et al. (2021, July 26). Blocking the GITR-GITRL pathway to overcome resistance to therapy in sarcomatoid malignant pleural mesothelioma. Retrieved March 11, 2024, from https://www.nature.com/articles/s42003-021-02430-5.
  6. Espinoza-Mercado, F., & Borgella, J. (2019, April 17). Disparities in Compliance With National Guidelines for the Treatment of Malignant Pleural Mesothelioma. Retrieved March 11, 2024,  from https://www.annalsthoracicsurgery.org/article/S0003-4975(19)30559-4/fulltext.
  7. Gray, S., & Mutti, L. (2020, February). Immunotherapy for mesothelioma: A critical review of current clinical trials and future perspectives. Retrieved March 11, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082257/.
  8. Kawabe, K., et al. (2022, May 30). Adenomatoid mesothelioma arising from the diaphragm: a case report and review of the literature. Retrieved March 11, 2024, from  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-022-03420-9.
  9. Klotz, L.V., et al. (2022, November). Multimodal therapy of epithelioid pleural mesothelioma: improved survival by changing the surgical treatment approach. Retrieved March 11, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9742626/.
  10. Kottangal, G., et al. (2022, May 19). Pleural malignant deciduoid mesothelioma: Case report of a rare variant of epithelioid mesothelioma. Retrieved March 11, 2024, from https://www.researchgate.net/publication/360743979_Pleural_malignant_deciduoid_mesothelioma_Case_report_of_a_rare_variant_of_epithelioid_mesothelioma
  11. Nakajima, E., et al. (2022, February 1). FDA Approval Summary: Nivolumab in Combination with Ipilimumab for the Treatment of Unresectable Malignant Pleural Mesothelioma. Retrieved March 11, 2024, from https://www.annalsthoracicsurgery.org/article/S0003-4975(19)30559-4/fulltext
  12. Nelson, B., et al. (2017, August 17). Long-Term Survival Outcomes of Cancer-Directed Surgery for Malignant Pleural Mesothelioma: Propensity Score Matching Analysis. Retrieved March 11, 2024, from https://ascopubs.org/doi/10.1200/JCO.2017.73.8401
  13. Okabe, K., et al. (2021, October). The Results of Multimodal Treatment With Extrapleural Pneumonectomy for Female Epithelioid Malignant Pleural Mesothelioma. Retrieved March 11, 2024, from https://www.jto.org/article/S1556-0864(21)02851-3/fulltext.
  14. Ollila, H., et al. (2022, June). Prognostic Role of Tumor Immune Microenvironment in Pleural Epithelioid Mesothelioma. Retrieved March 11, 2024, from https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.870352/full.
  15. Oshikiri, H. (2022, March 16). Benign multicystic peritoneal mesothelioma occurring in bilateral inguinal canals metachronously: a case report. Retrieved March 11, 2024, from https://link.springer.com/article/10.1186/s40792-022-01399-5.
  16. Shin, H., & Kim, S. (2016, April 16). Benign Cystic Mesothelioma Misdiagnosed as Peritoneal Carcinomatosis. Retrieved March 11, 2024, from https://karger.com/crg/article/10/1/120/87502/Benign-Cystic-Mesothelioma-Misdiagnosed-as
  17. Smith-Hannah, A., & Naous, R. (2019, January). Primary peritoneal epithelioid mesothelioma of clear cell type with a novel VHL gene mutation: A case report. Retrieved March 11, 2024, from https://www.sciencedirect.com/science/article/pii/S0046817718303034
  18. Stevers, M., et al (2018, August 31). Well-differentiated papillary mesothelioma of the peritoneum is genetically defined by mutually exclusive mutations in TRAF7 and CDC42. Retrieved March 11, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6309365/.
  19. Taylor, L., et al. (2019, July 8). Malignant deciduoid mesothelioma: a rare variant of epithelioid mesothelioma. Retrieved March 11, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615802/.
  20. Texas Oncology (n.d.). Stage I-III Malignant Pleural Mesothelioma. Retrieved March 11, 2024, from https://www.texasoncology.com/types-of-cancer/mesothelioma/stage-i-iii-malignant-pleural-mesothelioma/.
  21. UPMC Hillman Cancer Center. (n.d.) Mesothelioma Types, Risks, Diagnosis, & Treatment. Retrieved March 11, 2024, from https://hillman.upmc.com/cancer-care/lung/types/mesothelioma.
  22. U.S. National Library of Medicine (2023). Neoadjuvant Durvalumab and Tremelimumab With and Without Chemotherapy for Mesothelioma. Retrieved March 11, 2024, from https://classic.clinicaltrials.gov/ct2/show/NCT05932199.
  23. Verma, V. et. al. (n.d.). Survival by Histologic Subtype of Malignant Pleural Mesothelioma and the Impact of Surgical Resection on Overall Survival. Retrieved March 11, 2024, from https://pubmed.ncbi.nlm.nih.gov/30224273/.
  24. Yaziji H., et. al. (n.d.). Evaluation of 12 Antibodies for Distinguishing Epithelioid Mesothelioma From Adenocarcinoma: Identification of a Three-Antibody Immunohistochemical Panel With Maximal Sensitivity and Specificity. Retrieved March 11, 2024, from https://pubmed.ncbi.nlm.nih.gov/16554731/.