Mesothelioma is a rare type of asbestos-related cancer affecting a tissue lining, known as the mesothelium, that lines the outside of several organs and sections of the body. Pericardial mesothelioma is one of the rarest types of this aggressive, malignant cancer and is responsible for only about 1 percent of new mesothelioma cases each year.
Like other mesothelioma types, pericardial mesothelioma can take as much as 20 to 50 years to develop after the exposure to asbestos occurred. Because the disease is very rare and highly aggressive, those who are diagnosed with this type of cancer should seek the advice of a physician who is a specialist in the treatment of pericardial mesothelioma.
About Pericardial Mesothelioma
The pericardium is a mesothelioma layer of membrane which surrounds the heart. Pericardial mesothelioma is nearly always related to asbestos exposure. Mesothelioma may also affect other organs and sections of the body including the lungs (pleural mesothelioma), abdomen (peritoneal mesothelioma), and testicles (testicular mesothelioma).
Asbestos is a naturally-occurring mineral which is made of thin, needle-like fibers that may be inhaled or ingested and lodge in body tissues such as the pericardium. Over a period of 20 to 50 years, the asbestos may cause genetic mutations and inflammation which eventually leads to uncontrolled cellular division and the formation of tumors.
Most cases of mesothelioma are caused by occupational exposure to asbestos which was previously used as a high-heat insulator in certain industries. Those at the highest risk for pericardial mesothelioma worked in the steel, pipe-fitting, ship building, and automotive manufacturing industries, along with workers in demolition and certain types of construction. People whose family members had occupational exposure may also be at risk and develop mesothelioma from contact with dust which was transported into the living environment on contaminated clothing.
Though asbestos is no longer widely used in most industries, some products do still contain the mineral and many people remain at risk due to the latency period. Only about 3,000 new cases emerge each year but the number of those at risk is much higher. Because pericardial mesothelioma development surrounds the heart, it is often fatal and undetected while the victim is alive but some cases that are caught in early stages may be treatable by a mesothelioma specialist.
Pericardial Mesothelioma Symptoms
Symptoms of pericardial mesothelioma are caused by inflammation and the growth of tumors in the sac or lining around the heart, known as the pericardium. In addition to tumor formation, fluid collection in the pericardial sac is also common and causes many of the symptoms of pericardial mesothelioma.. Symptoms of pericardial mesothelioma may include:
- Irregular heartbeat – caused by tumor formation and cardiac compression due to fluid collection
- Chest pain – due to tumor formation and fluid collection around the heart
- Shortness of breath – caused by tissue swelling and fluid collection in the pericardium which may compress the lungs
- Fatigue – a general symptom of cancer and due difficulty breathing and irregular heart rhythm
- Weight loss – due to lack of food intake and also a general symptom of cancer
- Fever – from inflammation caused by cancer
Symptoms of pericardial mesothelioma may develop slowly and worsen over time as the cancer affects more of the heart and surrounding tissue.
Diagnosing Pericardial Mesothelioma
Because the time between asbestos exposure and development of pericardial mesothelioma is so long, it can be difficult it diagnose. Symptoms may appear to be other disorders and as the cancer is so rare, it is not uncommon for misdiagnosis to occur.
When symptoms are persistant and other diseases have been ruled-out, the doctor may order imaging studies including:
- CT Scan
- PET Scan
When these studies show development of tumors or irregularities in the pericardium, blood tests may be ordered. These tests detect a specific protein released by the cancer cells into the blood. Upon confirmation, a biopsy may be performed to remove a small amount of tumor tissue. This sample will be examined under a microscope to confirm malignancy and identify the type of tumor cells.
Staging of Pericardial Mesothelioma
There is no specific staging system that has been defined for pericardial mesothelioma as the cancer is so rare but doctors who do identify the stage of the disease may use the TNM system. The TNM staging system is based on tumor size (T), lymph node involvement (N) and spread of the cancer to distant organs or metastasis (M).
If staging for pericardial mesothelioma is given it will include:
Stage 1 – Tumor has not penetrated beyond the pericardial layer and there are no cancer cells in surrounding lymph nodes. Pericardial mesothelioma is rarely diagnosed at this stage but it is the most treatable.
Stage 2 –Tumor is larger but has not spread much beyond pericardial area. There are also some cancer cells in local lymph nodes.
Stage 3 – Tumor is significantly larger or there is more than one. It has penetrated beyond surrounding tissue into the heart muscle, chest wall, lungs, and / or diaphragm. There are also multiple cancer cells in lymph nodes that are further from the heart.
Stage 4 – Cancer cells have traveled to other distant parts of the body and begun growing new tumors of mesothelioma on other organs such as the brain, kidneys, or liver.
Treatment of Pericardial Mesothelioma
Treatment options for pericardial mesothelioma are limited by how advanced the cancer is or by stages that have been determined. Factors such as which tissues have become involved, severity of symptoms and other patient specifics such as medical condition may also affect treatment choices.
Pericardial mesothelioma that is diagnosed at the earliest stages may be treatable but at later stages, treatment options are severely limited due to heart involvement. Options include:
- Surgery – removal of the tumor, along with a healthy area of tissue may be performed if tumors are small. It will likely be done with chemotherapy but is not usually used in later stages due to the importance of the heart muscle.
- Traditional chemotherapy – cancer-killing medications may be given through IV infusion or in oral form. Chemotherapy is sometimes the only option due to advancement of the disease or may be used with surgery. It may also be used to alleviate symptoms caused by large tumors..
- Newer treatments – new medications and immunotherapy agents which are still in development may be available as part of a clinical trial.
Radiotherapy or treatment with x-ray type energy beams intended to kill cancer cells is rarely used in pericardial mesothelioma because of the risk of damage to heart muscle.
Pericardial Mesothelioma Treatment Cost
The cost of treating pericardial mesothelioma is significant. In addition to medical costs, the patient and loved ones may have suffered from loss of wages and loss of life. Asbestos has been known to cause mesothelioma for many years and some victims have received lawsuit settlements reaching into the hundreds of millions of dollars.
In addition to lawsuit awards, a large fund which still contains an estimated $30 billion was establish to help mesothelioma victims and their loved ones. Any person affected by a mesothelioma diagnosis should seek an evaluation by a legal expert, experienced in handling mesothelioma cases. Each case of is unique and there are no guarantees of success but many pericardial mesothelioma victims may be eligible for assistance.