The disease develops in the pericardium, a membrane that surrounds the heart and provides protection and support to the heart. The membrane has two layers: an outer layer called the parietal layer (called the heart sac or theca cordis), and an inner layer known as the visceral layer (called the epicardium). The parietal layer is part of a larger membrane that lines the entire chest cavity, while the visceral layer is the pericardial membrane that lines the heart.
Pericardial Mesothelioma Prognosis
Pericardial Mesothelioma Symptoms
Symptoms for pericardial mesothelioma can be very similar to other heart conditions, making it difficult to diagnose.
An additional problem is that the symptoms of pericardial mesothelioma resemble symptoms of other heart conditions, and this makes the cancer relatively difficult to diagnose quickly. Because of the similarity of symptoms, a doctor may perform a variety of tests to confirm the presence of pericardial mesothelioma cancer.
As with all other forms of mesothelioma, symptoms do not arise until later stages of cancer development. All asbestos-related diseases exhibit a latency period while the asbestos fibers slowly cause cellular damage within the exposed person's body. It typically takes decades for the lodged asbestos fibers to cause enough cellular damage to result in disease. Once cancerous changes have taken place in the cells, reporduction of those cells can lead to the accumulation of tumors and onset of symptoms.
Most pericardial mesothelioma symptoms are caused by the build-up of fluid and the thickening of pericardial layers. The following symptoms may indicate pericardial mesothelioma.
- Heart palpitations or irregular heartbeat (arrhythmia)
- Chest pain
- Murmurs
- Cough
- Difficulty breathing, even when at rest (dyspnea)
- Orthopnea (dyspnea which occurs when lying down)
- Fatigue
- Fever or night sweats
Pericardial Mesothelioma Treatments
Most people diagnosed with this form of mesothelioma are not good candidates for cancer surgery. However, there are rare cases where the cancer is diagnosed early, and surgery can be carried out to remove small, localized pericardial tumors. This type of surgery carries great risk, simply due to the proximity of the heart.
Prognosis for those with pericardial mesothelioma is grim and palliative treatment is usually the only option for people diagnosed with pericardial mesothelioma. This type of treatment is performed to improve a patient's quality of life, and reduce the severity of symptoms caused by the build-up of fluid in the pericardium. Fine needle aspiration may be carried out to remove excess fluid as well. In some cases, radiation therapy may be an option. Unfortunately, the proximity of the heart and lungs make this a risky prospect.
Treatment for this type of mesothelioma is almost purely palliative. Roughly 50 to 60 percent of pericardial mesothelioma patients are claimed by the disease within six months of diagnosis. One patient survived five years following treatment of partial surgical resection and radiation. One other patient survived one year after a similar treatment approach.
Pericardial Mesothelioma Diagnosis
A fast and accurate diagnosis of pericardial mesothelioma is difficult, due to the non-specificity of the symptoms of this type of cancer.
To diagnose pericardial mesothelioma, a patient's symptoms, medical history, and current medical condition must all be assessed. The initial stages of diagnosis involve taking a medical history and undergoing a thorough physical examination.
Following these initial steps, a variety of imaging tests may be required to determine exactly where cancer is located. Magnetic resonance imaging (MRI) has been found to be the most effective at assessing the disease and determining the extent of its development. The final stage of diagnosis typically involves a biopsy to confirm the point of origin of the cancer. A biopsy involves the removal of tissue or fluid from the pericardium, followed by laboratory tests of the tissue and fluid to confirm the presence of mesothelioma.
In sum, medical professional typically take a comprehensive approach to diagnosing this disease, recommending analysis of gross appearance, proteins of cancerous cells and electron microscopy.
How Does Asbestos Cause Pericardial Mesothelioma?
It has long been known that pleural mesothelioma , which develops in the lining of the lungs, is caused by inhalation of asbestos fibers. However, the way in which asbestos causes the development of pericardial mesothelioma is not very well understood. Scientific research has yet to reveal a clear correlation between this disease and exposure to asbestos, but a number of patients with pericardial mesothelioma have a history of asbestos exposure.
Some experts believe that inhaled asbestos fibers travel via the bloodstream from the lungs to the heart, although there is no conclusive evidence to support this theory.
What is known is that asbestos fibers somehow become lodged in the pericardial membranes that surround the heart. When this occurs, the body experiences extreme difficulty in eliminating the asbestos fibers and they can remain stuck in the membranes. Over a long period of time, sometimes two decades or more, the asbestos fibers cause the cells of the pericardium to undergo changes that may result in cancer.
Once cells become cancerous they begin to divide more rapidly, without the restraint that regulates the growth cycles of normal healthy cells. As these malignant pericardial mesothelioma cells continue to grow they lead to the thickening of the pericardial membranes, and eventually cause tumors to develop. These changes in the pericardial membrane lead to the build-up of fluid between the pericardial layers, which, combined with the thickening of the layers, puts pressure on the heart.
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