Pericardial Mesothelioma

Quick Summary

Pericardial mesothelioma is a rare type of cancer caused by asbestos exposure. It develops within the protective lining that covers the heart, called the pericardium. Pericardial mesothelioma is a deadly disease for which there is no cure. In the majority of cases, pericardial mesothelioma isn’t diagnosed until an autopsy is performed after the patient has passed away.

Pericardial Mesothelioma Overview

All patients diagnosed with pericardial mesothelioma should know the following things about this disease:

What Is Pericardial Mesothelioma?

Pericardial mesothelioma is an exceedingly rare and aggressive form of cancer. Only 3,000 cases of mesothelioma are diagnosed annually in the United States and less than 1% of these are attributed to pericardial mesothelioma. Most people diagnosed with pericardial mesothelioma survive less than one year, with the median life expectancy at 6 months.

Pericardial mesothelioma occurs when tumors form in the protective tissue lining that covers and protects the heart muscle. The pericardium is composed of an inner and outer layer and the tumors may form in either layer and slowly spread. Pericardial mesothelioma tumors form after the affected person has been exposed to asbestos, and the fibers become lodged inside the pericardium.

Like all mesotheliomas, pericardial mesothelioma has a long latency period. It can take 10-50 years for symptoms to develop after the person was initially exposed to asbestos. This delayed onset of symptoms makes pericardial mesothelioma incredibly difficult to detect, diagnose and treat. However, if diagnosed, patients with pericardial mesothelioma can rest assured that there are treatment options available no matter how advanced the disease is.

What Causes Pericardial Mesothelioma?

Like all forms of mesothelioma, there is only one known cause of pericardial mesothelioma—asbestos exposure. Virtually everyone employed in industrial manufacturing or construction trades during the 20th century would have been exposed to asbestos on the job. Asbestos was a commonplace material touted for its insulation and fire-resistance properties. As an exceptionally durable material, asbestos made what was believed to be the perfect product.

Asbestos is mined directly from the ground and is considered a group of multiple different minerals. It’s comprised of millions of tiny tinsel-like particles that can disperse into the air whenever disturbed. Anyone working around asbestos could have unknowingly breathed in or ingested these microscopic shards.

Once asbestos fibers enter the system, they work their way into the mesothelial linings (protective coverings) of different organs, including the heart lining—the pericardium.

How Asbestos Leads to Pericardial Mesothelioma

Experts are still unsure exactly how asbestos fibers end up in the pericardium. Unlike pleural and peritoneal mesotheliomas which are caused by inhaling and ingesting asbestos fibers respectively, it remains unclear the exact path these toxins take to get to the heart. Regardless of how they get there, once they’ve worked their way into the pericardium, the asbestos fibers can never be expelled.

Over time, trapped asbestos fibers cause irritation and inflammation of the healthy pericardial tissue. With enough irritation, healthy cells develop genetic mutations, which cause them to grow and divide at higher than normal rates. Abnormal cell growth is the basis of all cancers and left untreated, cancer cells continue to mass together into clumps called malignant (cancerous) tumors.

As tumors grow, they prevent the affected organs from functioning properly. Pericardial mesothelioma tumors affect the heart, which can eventually be fatal. Radical surgeries can help protect the heart and possibly extend life; however, few patients are healthy enough for these procedures. Pain management therapies can increase comfort and quality of life for pericardial mesothelioma patients.

What Are the Symptoms of Pericardial Mesothelioma?

Because of where pericardial mesothelioma develops, its signs have to do with heart function. It also creates many other vague symptoms, which make it difficult to detect initially. Pericardial mesothelioma is often mistaken for other heart conditions because it’s such an uncommon form of cancer. This often leads to fatal misdiagnoses.

Because there have been so few cases, pericardial mesothelioma symptoms are still being identified.

However, patients have reported the following primary signs:

  • Chest pain
  • Shortness of breath
  • Cough
  • Irregular heartbeat
  • Heart murmurs
  • Swelling of the face and arms
  • Fever and sweating
  • Fatigue

All mesotheliomas cause thickening to the mesothelial tissue as the disease worsens. In pericardial mesothelioma, tumors cause the pericardium to become inflamed—a condition called pericarditis. The pericardium layers also begin to fill with fluid (pericardial effusions). This is a key sign that doctors look at when making a pericardial mesothelioma diagnosis. They use fluid samples from the pericardium to test for the presence of mesothelioma.

As with all forms of mesothelioma, there is a 10 to 50-year delay in the time between asbestos ingestion and the development of symptoms that are severe enough to lead to a diagnosis. Though it’s a rare cancer, it’s important to see your doctor immediately if you experience any of the above symptoms and you have a known history of asbestos exposure.

Pericardial Mesothelioma Treatments

Treatment Update

Pericardial mesothelioma is a difficult, but not impossible condition to treat. Patients can rest assured that no matter how advanced the disease is, doctors can always provide treatment in some form or another. Depending on how far advanced your condition is, the treatments goals will differ.

For example, pericardial mesothelioma that is still contained in the pericardial layer may be treated using surgery and chemotherapy to prevent the disease from spreading further. However, pericardial mesothelioma that has already spread to distant sites can be treated using palliative therapies, which reduce pain and make the patient comfortable.

Because pericardial mesothelioma is so rare, it’s difficult to determine any one standard treatment approach. Rather, doctors recommend treatments entirely based on the unique case at hand. Pericardial mesothelioma treatments may include a combination of surgery, chemotherapy, palliative therapy and even novel treatments offered in clinical trials.

Pericardiectomy

In rare cases, patients report their pericardial mesothelioma symptoms early enough to receive a diagnosis before the disease has spread to distant sites. In these cases, doctors may decide that their patient is a good candidate for a procedure called the pericardiectomy, which removes the diseased pericardium in part or full. This is a risky procedure because of the proximity to the heart, which is delicate and can result in fatal complications.

During the pericardiectomy, the doctor removes whatever he or she feels is the most diseased part of the pericardium. The surgeon may also remove any visible tumors that have spread around the pericardium. Tumor removal helps increase a patient’s quality of life by reducing fluid building and alleviating pressure.

Ultimately, doctors approach this procedure based on what they think will give the patient the greatest shot a long-term survival.

Chemotherapy

Little is known about the most effective way of treating pericardial mesothelioma with chemotherapy. However, certain drug combinations have shown to help manage the disease and improve symptoms, possibly leading to longer life expectancy.

An effective chemotherapy drug combination for mesothelioma is pemetrexed and cisplatin, which has shown positive results in pleural mesothelioma patients. Some doctors may recommend this medication approach for pericardial mesothelioma patients as well to help control the disease and possibly extend life.

Researchers are currently investigating another chemotherapy drug called gemcitabine. As an anti-cancer drug, gemcitabine has shown to help slow down the progression of mesothelioma and alleviate painful symptoms—a key goal in treating pericardial mesothelioma.

Palliative Treatments

Because pericardial mesothelioma is so advanced by the time doctors detect it, most patients undergo a treatment plan that is focused on palliative care. End-stage cancer requires a different emphasis on care, which is what the medical community refers to as palliative. During palliative treatment, the doctor’s goal is to make the patient as comfortable as possible by alleviating symptoms.

Pericardial symptoms such as tightness in the chest and difficulty breathing can be solved with procedures that alleviate swelling and fluid accumulation. Doctors can do this by draining fluid from the pericardium, which reduces pressure.

Get in Touch With a Pericardial Mesothelioma Specialist

If you’ve been diagnosed with pericardial mesothelioma, then it’s essential to work with a mesothelioma specialist. Pericardial mesothelioma is the rarest form of an already uncommon cancer. For this reason, general oncologists do not have the technical expertise to accurately diagnose and treat pericardial mesothelioma like specialists do. Oncological surgeons specializing in the treatment of mesothelioma are available to help you at cancer centers across the country.

Additionally, pericardial mesothelioma patients can benefit from some of the novel treatments available through leading clinical research. Many of these new treatments, that are not yet available as standard treatments, can possibly extend your life.

Here are some of the top cancer centers with mesothelioma clinical trial programs:

Contact any of these cancer centers directly to make an appointment for an evaluation. Specialists look at each patient case to determine if they are a good candidate for clinical trials. It’s also important to note that clinical trials are not paid-for treatments like regular health care services at hospitals. In many cases, the organization leading the clinical trial will compensation patients for their time and expenses.

For more information on how to receive compensation for pericardial mesothelioma treatments, contact our Patient Advocates today. We’re here to help you file a claim as an asbestos victim so you can receive the legal compensation you’re entitled to. Do not delay in filing your claim as this can prevent you from receiving timely and potentially life-saving treatments.

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Sources
  1. National Institutes of Health, Primary pericardial mesothelioma presenting as pericardial constriction: a case report” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767997/. Accessed on December 13, 2017.

Last modified: May 7, 2018