Understanding Pericardial Mesothelioma
Of all the types of mesothelioma, pericardial is the least common. It accounts for an estimated 1 percent of all mesothelioma cases, with approximately 150 known cases worldwide.
Pericardial mesothelioma is an aggressive disease that causes tumors to form in the heart lining. This makes it difficult, but not impossible, to treat. Surgical removal of small tumors is possible in some cases. Surgery minimizes symptoms and extends the life expectancy of patients.
Some cases have shown that surgical procedures that remove pericardial mesothelioma tumors can extend patients’ lives by up to two years. Some pericardial mesothelioma patients have even gone on to survive five years or longer.
Pericardial Mesothelioma Causes
Pericardial mesothelioma is directly linked to asbestos exposure. Asbestos is a fibrous material that has been used traditionally in construction and industrial capacities. When disturbed, asbestos particles become airborne.
Airborne asbestos is susceptible to human inhalation and ingestion. When this occurs, asbestos particles can make their way into the heart lining (pericardium) where they become lodged permanently. It is still unclear exactly how asbestos fibers reach the pericardium.
Asbestos is extremely resistant to destruction and will never decompose. It also can’t leave the human system once inside. The body recognizes asbestos as a foreign material. This triggers irritation and inflammation inside the pericardium. This irritation and inflammation, when prolonged over the course of 20 or more years, causes the cells inside the pericardium to mutate. These mutated cells eventually become mesothelioma cancer cells.
Mesothelioma cells multiply and form tumor masses of cancer cells. These tumors continue to grow and spread until they eventually shut down nearby organs, including the heart. Treatment can remove the tumor and/or prevent the tumor from spreading further.
Pericardial Mesothelioma Symptoms
Pericardial mesothelioma affects the heart lining and produces a variety of symptoms. As with all forms of mesothelioma, pericardial mesothelioma symptoms don’t present themselves until decades after the initial exposure to asbestos. It takes 20 to 40 years before the asbestos inside the pericardium causes enough irritation to produce cancer cells. Even then, it can take many years for cancer cells to spread enough to cause noticeable damage.
When the first pericardial symptoms appear, they are often subtle and easily confused with other conditions like cardiovascular disease or an irregular heartbeat.
Notable pericardial mesothelioma symptoms include:
- Shortness of breath
- Heart palpitations
- Chest pain and tightness
- Persistent, nonproductive cough
These symptoms are caused by continued fluid buildup inside the pericardium. As tumors grow, they create pressure in the heart, leading to buildup and the negative symptoms.
These symptoms may at first go undetected or be misdiagnosed since pericardial mesothelioma is so rare. Seeing a mesothelioma specialist and discussing your past exposure to asbestos is critical to receiving a proper diagnosis and the right treatments to extend your life.
Pericardial Mesothelioma Diagnosis
As with all types of mesothelioma, pericardial mesothelioma is diagnosed in three stages. Following these three steps helps doctors learn as much about your condition as possible so they can better understand how to treat it.
Here are the steps doctors take in diagnosing pericardial mesothelioma:
1. Assess Symptoms
When you present symptoms of pericardial mesothelioma, your doctor will complete a physical examination by listening to your breathing and your heartbeat. They will ask about your symptoms and how long you’ve had them. It’s critical in this step to tell doctors about your history of asbestos exposure as this can point them in the right direction.
2. Perform Tests
After reviewing symptoms, doctors will order tests to investigate further. Imaging scans like CT scans and X-rays can help doctors identify if there is a tumor and where it’s located. Doctors also use echocardiograms to monitor the heart and determine if it’s pumping blood properly. These exams are important because they also tell doctors how severe the mesothelioma is by amount of damage to the heart and how far it has spread.
3. Conduct Biopsies
Once doctors recognize that tumors are affecting the pericardium, they then determine if the tumors are malignant mesothelioma. Doctors do this through a biopsy, a procedure that collects samples of tissue cells from the pericardium.
Doctors then look at these cells under a microscope to determine if they are mesothelioma cells. If they find mesothelioma cells in the tissue from the pericardium, they can make a final diagnosis.
Pericardial Mesothelioma Prognosis
Along with a diagnosis, doctors also provide a prognosis. A prognosis is the likely course of the disease and how it will progress based on similar patient cases. A prognosis also tells patients how long the can expect to survive after their diagnosis.
Pericardial mesothelioma has a poor prognosis because of its limited treatment options. The average life expectancy of those diagnosed with pericardial mesothelioma is 6 months. However, many patients have beaten the odds and have survived 3 years or longer after an initial diagnosis. Some patients with pericardial mesothelioma have survived over 5 years.
Treatment is a major factor when determining a pericardial mesothelioma prognosis. A multimodal treatment plan can shrink tumors and kill cancer cells, which increases life expectancy and the likelihood of survival.
Pericardial Mesothelioma Treatments
Though pericardial mesothelioma is an aggressive disease, there are still important treatment options for patients to pursue. Treatment options are limited because of how close tumors are to the heart, but surgery is still possible.
Pericardiectomy surgery is an important procedure doctors perform to remove some or all of the pericardium, which removes many tumors in the process. Patients who are eligible for this surgery can dramatically improve their life expectancy and benefit from reduced symptoms.
Doctors will also use chemotherapy to treat pericardial mesothelioma. Certain chemotherapy drugs like gemcitabine have shown promising results in slowing down the disease progression and shrinking tumors.
Additional studies on drugs like gemcitabine are being conducted in clinical trials. Talk to your health care team about participating in clinical trials so you can take advantage of these promising new treatments.