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PERICARDIAL MESOTHELIOMA

Mesothelioma is a cancer that affects the thin membrane protecting several of the body’s most important organs, including the lungs, abdomen and heart.  Treatment for this disease includes surgery, chemotherapy and radiation therapy. 

Pericardial mesothelioma originates in the pericardium, the protective membrane lining the heart.  This disease accounts for approximately 1 percent of all mesothelioma diagnoses and has a generally poor prognosis.  But there are surgical and chemotherapeutic options that can extend survival time. 

Since it is one of the rarest forms of mesothelioma, researchers have studied pericardial mesothelioma less than pleural or peritoneal types.  As more cases of pericardial mesothelioma surface, however, researchers will develop more treatment options.  These treatment options start out in clinical trials, which may be recruiting now. 

What treatments work?  Treatments like the pericardiectomy and chemothearpy can improve a patient’s quality of life.  There are some notable cases of treatments managing the spread of this cancer for significant lengths of time. 

What’s the prognosis for this disease?  Most pericardial mesothelioma patients have a prognosis of 6 months.  Yet, there are always exceptions to the rule.  Talk to someone who can help you explore potential treatment options. 

Treatments

Treatment for pericardial mesothelioma has not been fully developed due to the rarity of the disease.  Because the pericardial lining is so close to the heart, specialists limit treatment for pericardial mesothelioma to localized patches of tumor growth.  This minimizes damage to the heart during surgery or targeted radiation therapy. 

Most treatments for pericardial mesothelioma are palliative in nature.  Palliative treatments are pain relieving procedures designed to make patients more comfortable. 

Common treatments for this disease include:

Pericardiectomy.  This surgical procedure involves the partial or whole removal of the pericardium.  Tumor growth in the pericardium causes irritation of the mesothelial lining.  During the procedure, a surgeon removes the irritated lining of the heart.  This eases the constriction caused by inflammation.  Patients may have a partial or whole pericardiectomy.  Surgeons perform these procedures to stop recurring symptoms, such as painful fluid buildup.  After surgery, the pericardium is reconstructed with artificial materials, such as Gore-tex, a breathable membrane made of fabric. 

Pericardiocentesis.  Specialists use a pericardiocentesis to relieve the pressure caused by pericardial effusions.  With the help of echocardiography to locate the effusion, a surgeon inserts a needle into the tissue surrounding the heart.  The surgeon replaces the needle with a small catheter to drain the buildup of fluid in the pericardial sac. 

Chemotherapy.  The most common type of treatment for all cancers, chemotherapy can slow pericardial tumor growth, preventing harsh symptoms and potentially extending life.  One study showed that a combination of gemcitabine, cisplatin and vinorelbine stopped the progression of pericardial mesothelioma in one patient for two years. 

Symptoms

Because pericardial mesothelioma is so rare, symptoms often often go unnoticed until the disease has reached an advanced stage.  The buildup of excess fluid in the pericardial sac (pericardial effusion) and thickening of the pericardium cause the symptoms of this disease.  Pericardial thickening and effusions prevent the heart from expanded and contracting normally. 

Symptoms caused by pericardial mesothelioma include:

Dyspnea, or difficulty breathing

Persistent coughing

Heart palpitations

Chest pains

Fatigue

Fever

Diagnosing Pericardial Mesothelioma

Most cases of pericardial mesothelioma are diagnosed at an advanced stage, often during surgery or treatment for another issue.  This is because the symptoms of pericardial mesothelioma are similar to symptoms found in many other more common diseases.  Although it’s rare, early diagnosis allows for a more effective course of treatment. 

The diagnostic process begins with a physical examination.  Doctors examine the patient to confirm symptoms.  Then doctor’s use imaging tests, such as a CT scan or MRI, to locate the source of the symptoms. 

Once doctors locate a tumor or fluid buildup, they perform a biopsy.  During a biopsy, a specialist removes fluid or tissue from the affected area.  The samples are sent to a lab where a series of tests are performed to confirm the diagnosis. 

Common tests used to diagnose pericardial mesothelioma include:

Echocardiogram: A diagnostic test that uses soundwaves to track heart function.  Symptoms such as pericardial thickening can impair the regular functions of the heart.  An echocardiogram can pick up on signs of abnormal functioning and help diagnose pericardial mesothelioma. 

Effusion cytology: A pathologist examines a suspected fluid sample for traces of mesothelioma.  Doctors extract the fluid from buildup around the heart, a procedure known as pericardiocentesis.  This procedure has a 20 percent success rate in confirming mesothelioma. 

Prognosis

Patients diagnosed with pericardial mesothelioma have a less favorable prognosis than patients with pleural or peritoneal mesothelioma.  Since pericardial mesothelioma is rare, it is not seen as often as the other types.  Less research is carried out on pericardial mesothelioma, which has resulted in less refined methods of diagnosis and treatment. 

The average life expectancy for most pericardial patients is less than one year. 

But there is evidence of patients living longer than ever before.  People who seek out clinical trials give themselves a wider choice of treatment options and a better chance at improving their prognosis.