Pericardial Mesothelioma

Summary

Pericardial mesothelioma is a rare type of cancer caused by asbestos. It forms in the lining of the heart (pericardium) and has a poor prognosis. If detected, pericardial mesothelioma can be treated using a combination of surgery and chemotherapy that can potentially extend life expectancy.

Pericardial Mesothelioma Overview

If you’ve been diagnosed with pericardial mesothelioma or your doctor suspects you may have it,  here is what you need to know about this disease:

  • An extremely hard cancer to detect and can only be properly diagnosed by a specialist
  • The rarest form of all three mesothelioma locations accounting for only 1% of all new cases
  • Most patients live between 6 and 12 months with this disease but can improve life expectancy with treatment
  • Standard treatments include aggressive surgeries, chemotherapy and palliative care
  • Clinical trials provide new and novel treatments to help improve the quality of life of pericardial mesothelioma patients
  • Only medical or cardiac oncologists specializing in mesothelioma can effectively treat this disease

What is Pericardial Mesothelioma?

A rare and complex cancer, pericardial mesothelioma is not yet fully understood by researchers. Pericardial mesothelioma happens when malignant (cancerous) tumors form in the protective tissue lining that covers the heart muscle. Organ linings are called the mesothelium, and the mesothelium that protects the heart is called the pericardium. It’s extremely rare for cancers to form in this area of the heart, and one of the reasons it can form is due to asbestos exposure.

Pericardial mesothelioma is one of three primary asbestos-caused cancers that form in the mesothelium. The other two are far more common. Roughly 80% of mesothelioma cases are pleural (lungs) and 20% of cases are peritoneal (abdomen). Fewer than 150 cases of pericardial mesothelioma have ever been identified in medical reports.

While pericardial mesothelioma has the worst prognosis (outlook) due to its proximity to the heart, there are treatments that can possibly remove or control the cancer and extend patients’ lives.

What are the Symptoms of Pericardial Mesothelioma?

All mesotheliomas are difficult to detect because of their vague symptoms. Given it’s rarity, it’s easy for doctors to mistake pericardial mesothelioma symptoms for other far more common conditions. Additionally, mesotheliomas have a long latency (delay) period of 10-50 years between the time of the initial disease cause and the diagnosis.

Here are some of the recorded symptoms of pericardial mesothelioma:

  • Chest pain
  • Heartbeat irregularities
  • Heart murmurs
  • Fluid buildup around the heart (pericardial effusion)
  • Unexplained weight loss
  • Fever, night sweats and fatigue

MJN Brief

The most significant sign of pericardial mesothelioma is an irregularity in the pericardium such as thickening or fluid buildup. Both of these are caused by inflammation due to metastasizing  (spreading) tumors in the pericardium.

 

If you are experiencing any of these symptoms it’s critical to tell your doctor about your past exposure to asbestos. Asbestos is the only known cause of mesothelioma and can be linked to pericardial mesothelioma. By knowing your history of asbestos use, doctors can diagnose your condition and provide treatments sooner.

What Causes Pericardial Mesothelioma?

Researchers have identified asbestos exposure as the only known cause of all mesotheliomas. A prolific material used in the 20th century, asbestos was directly handled by countless industrial, blue-collar workers and veterans. Asbestos fibers are microscopic and tinsel-like. When disturbed, such as through handling or demolition, the fibers get released into the air where they become inhaled or ingested by nearby people. When asbestos fibers enter the human body, they become trapped within the mesothelium of various organs, including the heart’s pericardial layers.

Trapped asbestos fibers cause irritation and inflammation to the pericardium, eventually triggering genetic mutations to surrounding healthy cells. Genetic mutations cause mesothelial cells to grow at abnormally fast rates and clump together to form tumors. As tumors build from increased mesothelioma cancer cells, they spread to distant sites, compromising the heart and lymphatic system (the body’s filtration points). Left untreated, pericardial mesothelioma becomes fatal often to due to heart failure as a result of significant metastasis.

It’s important to note that only a quarter of pericardial mesothelioma cases involve someone with a past history of mesothelioma exposure.

It’s possible that many of the people diagnosed with pericardial mesothelioma had a unknown history of asbestos exposure. Additionally, because the majority of cases are diagnosed at autopsy, the patient’s loved ones may not have known details about their history of asbestos exposure.

Who Gets Pericardial Mesothelioma?

Most people who develop pericardial mesothelioma are men. Because of how asbestos was used, the majority of people exposed to it were males who occupied roles traditionally held by men. And due to the latency period of developing mesothelioma symptoms, most pericardial mesothelioma patients are around the age of 55 with some being much younger or older.

It’s important for everyone to know that pericardial mesothelioma can affect anyone with a history of asbestos exposure. Women and young people can develop this deadly cancer as well. One case report showed at 19-year-old man diagnosed with pericardial mesothelioma.

Learn more about who is at risk of asbestos exposure by visiting our Occupations page.

Pericardial Mesothelioma Stages

Conventionally, doctors stage cancer to determine the level of severity the disease has reached at diagnosis. However, because pericardial mesothelioma is so rare, it’s difficult for doctors to identify common staging factors across all cases. Therefore, doctors give a general stage of advanced vs. localized (contained to the original spot).

Unfortunately, most cases are diagnosed at significantly advanced stages. But knowing how far the mesothelioma has spread is incredibly important for doctors. Disease stage helps them develop effective treatment plans on a case-by-case basis.

Peritoneal Mesothelioma Treatments

Pericardial mesothelioma has standard treatments no matter how advanced it is. Over the past 15-20 years, significant advancements have been made in mesothelioma research, which have led to the development of new treatment approaches that can give patients a better chance at survival.

The best pericardial treatment results happen because patients have been seen by specialists.

Factors that contribute to effective treatment plans include:

  • Diagnosis by an experienced pathologist who can identify this rare cancer type
  • Treatment by a multidisciplinary team of doctors
  • Aggressive surgeries conducted by highly skilled cardiac surgeons

A standard surgery for pericardial mesothelioma patients is the pericardiectomy, which removes the diseased pericardium and any visible tumors in the area. Surgery is then followed by a weeks-long chemotherapy plan to help kill remaining mesothelioma cells left behind after surgery.

Learn more about Surgery for mesothelioma.

Certain chemotherapy approaches are showing promising results for pericardial mesothelioma patients. Medical oncologists—specialists who study and test chemo drug combinations—have identified one combination that has allowed some patients to live longer than two years. Chemo drugs cisplatin, gemcitabine and vinorelbine combined may help to slow disease progression and prevent recurrence.

Learn more about Chemotherapy Medications for mesothelioma.

Seeking Compensation for Pericardial Mesothelioma

Pericardial mesothelioma treatments are available at specialized cancer centers across the country. While all cancer centers accept major health insurance plans, some plans may not provide enough coverage for all costs associated with pericardial mesothelioma treatments.

A mesothelioma diagnosis is massive emotional financial burden that can be devastating to families. Pericardial mesothelioma patients are victims of asbestos exposure. As a result, you may qualify for legal compensation by filing a claim against one or more asbestos manufacturers. Compensation can cover financial obligations like treatments, travel, accommodations and any other damages you’ve suffered.

Veterans have an opportunity to receive additional compensation through the VA. Many veterans can prove that their mesothelioma diagnosis has been the result of asbestos exposure during their time with the military.

View Author and Sources
Sources
  1. Case Reports in Oncological Medicine, “Primary Pericardial Mesothelioma: A Rare Entity.” Retrieved from: https://www.hindawi.com/journals/crionm/2013/283601/. Accessed on December 30, 2017.
  2. Journal of Thoracic Disease, “Primary malignant pericardial mesothelioma—a rare cause of superior vena cava thrombosis and constrictive pericarditis.” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283333/. Accessed on December 30, 2017.
  3. Heart, “Primary pericardial mesothelioma presenting as pericardial constriction: a case report.”
    Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767997/. Accessed on December 30, 2017.

Last modified: February 3, 2018