Straight Talk about Mesothelioma, a blog series created by Michael T. Milano, M.D., Ph.D., a radiation oncology specialist, as a resource for mesothelioma patients and their loved ones.

Pericardial mesothelioma is a cancer that forms on the outside surface of the pericardium, which is the lining, or the sac, around the heart. It is extremely rare, accounting for only 5% of newly diagnosed cases of mesothelioma. All types of mesothelioma are aggressive, and this type is especially so. Further complicating matters is that diagnosis is difficult and often late in the disease’s progression. As a result there are few reported cases of survival beyond one year after diagnosis. In fact, many conclusive diagnoses are not made until a patient’s autopsy to confirm the cause of death.


Possibly because pericardial mesothelioma is so rare, the optimal treatment has not yet been established. This form of mesothelioma does not respond well to existing radiation therapies typically used for other types of mesothelioma. Radical surgery is the preferred treatment for pericardial mesothelioma that is localized.

New Approaches

While there is no known cure for this particularly aggressive type of mesothelioma, researchers are making tremendous headway into more precise ways of diagnosis, more finely targeted radiation, as well as new types of agents that use the wisdom of your own cells to combat the disease. Clinical trials are ongoing at leading research facilities across the United States. New areas of research include intracavitary chemotherapy, photodynamic therapy, immunotherapy, gene therapy, and brachytherapy (a type of radioactive implant).