Pericardial mesothelioma is a rare and fatal form of asbestos cancer. It is the least commonly diagnosed of the various types of mesothelioma, but can also be the most damaging and the hardest to treat.
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According to a study cited in the Texas Heart Institute Journal (THIJ), pericardial tumors of this type account for less than 10 percent of all types of mesothelioma. This means that 14 to 30 out of every million people are diagnosed each year on average.
The same study also states that in a sampling of 120 cases involving pericardial mesothelioma, three quarters of the diagnoses were made after the patients died. This illustrates the disease’s most vexing features – its slow development and insidious fashion of exhibiting symptoms which are normally indicative of other cardiopulmonary diseases – and its extremely aggressive nature.
Pericardial mesothelioma gets its name from the part of the body where it is found, the pericardium. The pericardium is the protective double-walled sac which surrounds the heart. This sac contains pericardium fluid, which protects the heart and its associated veins and arteries from external jolts or shocks.
When a mesothelioma tumor forms anywhere in the pericardial cavity, it will, over a long period of time, grow, become malignant, and eventually metastasize to other parts of the chest and abdomen. This cancer will eventually affect the cardiovascular system once it develops, with devastating consequences to the heart and lungs.
Development, Symptoms, and Diagnoses
Typically, the cancer forms on the outer lining of the pericardium. As a tumor grows over a period that can take as long as five decades before symptoms of mesothelioma show up, it can either remain localized in one area of the pericardium or completely surround a patient’s heart.
Once it has taken root, the tumor can then attack various parts of the cardiovascular system, including the atrium, coronary arteries, coronary sinuses, the myocardium, the heart’s conduction system, the lungs, or regional lymph nodes.
The problem with diagnosing this disease is that its resulting symptoms, such as shortness of breath, persistent coughing, and chest pains, are also associated with other cardiopulmonary diseases and thus mask the nature of the malignant mesothelioma.
In most cases, this cancer can only be detected by using imaging methods such as chest X-rays or magnetic resolution imaging (MRIs). By the time a patient’s doctor or referred oncologist discovers the tumor, however, chances are that it has already spread beyond the pericardium and metastasized to the lymph nodes or the lungs.
This has been the case in between 30% to 50% of cases involving pericardial mesothelioma. This explains why pericardial diagnoses are more frequently made postmortem.
Besides its lethality and relative rarity (it has a reported prevalence of less than 0.002%), pericardial has another vexing feature associated with it: Unlike other forms of malignant mesothelioma, the pericardial strain is the only one which is not almost exclusively linked to asbestos exposure.
In patients with, for example, pleural mesothelioma, the tumors in the pleural lining developed as a result of long-term exposure to asbestos fibers. When breathed in, these fibers caused lesions in healthy tissue. The tissue became cancerous over time and created malignant tumors.
The disease can develop as a result of exposure to asbestos, but medical research has also linked it to other contributing factors. These risk factors may include hereditary predisposition, conditions which affect the immune system, exposure to radiation, infections, diet, or various types of inflammations.
As with asbestos-related mesothelioma, pericardial tumors of this nature are presently incurable. Chemotherapy and, to a lesser extent, a form of surgery called pericardiectomy are used in patients with pericardial mesothelioma to cure localized tumors or to relieve the pressure on cardiac tissue.
It is important to note that most mesothelioma treatments cannot be treated by surgery alone; pericardiectomy operations are always carried out in conjunction with either chemotherapy or radiation.
However, while these forms of treatment reduce the size of the mesothelioma, they are only life-prolonging measures. Pericardiectomy operations, radiation, and chemotherapy can hardly ever remove tumors in their entirety.
In most cases where a patient has been diagnosed, the cancer has already spread to the nearby lymph nodes or the lungs. Yet, other forms of surgery are available to qualified candidates, which focus on removing parts of the cancers as opposed to the entire tumor. A physician will ultimately make the decision of which patients qualify for these surgeries.
Because malignant mesothelioma is a relatively new and extremely rare form of cancer, research into how to improve treatments is ongoing, and is expected to get better and scientists discover new methods.
On average, effective treatment helps extend a patient’s life expectancy. According to the Mesothelioma Applied Research Foundation (MARF), statistics show that about half of all mesothelioma patients can expect to live for a period which ranges from eight months to around a year and a half. A smaller number of patients, about 30% of the total, can extend their lives by an average of five years.
Naturally, each patient’s prognosis is unique and depends on variables such as age, general health, diet, and other lifestyle issues, such as smoking. In broad terms, patients in their 50s who exercise regularly, do not smoke and have no major health problems will have a better prognosis than older patients who are sedentary, smoke or were heavy smokers, and have pre-existing health problems, including other forms of cancer.
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