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Mesothelioma is a rare form of cancer linked to exposure to asbestos. Mesothelioma targets the protective membranes of the lungs, heart and stomach and is treated by surgery, chemotherapy and radiation.
There are three types of mesothelioma. Pleural is the most common form affecting the lining around the lungs. Peritoneal attacks the lining of the abdomen and is the second most common form. Pericardial attracts the lining of the heart and is the rarest, affecting only one percent of all mesothelioma diagnoses.
Because it is so rare, there has been much less research on pericardial mesothelioma than on the other forms. There is hope that more treatment options will be developed in the future.
New treatment options often begin as clinical trials.
Chemotherapy and pericardiectomy (surgery to remove the membrane around the heart) can help slow the spread of the cancer although the prognosis is generally six months. These are difficult treatment choices that require professional guidance.
Because pericardial mesothelioma is extremely rare, it is often not detected until advanced. It causes pericardial effusion which is a buildup of fluid in the pericardial sac and thickening of the pericardium, preventing normal heart expansion and contraction.
Symptoms mirror many more common heath issues and diseases. Diagnosis often occurs once the disease has reached an advanced stage and often detected during treatment or surgery for another issue.
Echocardiograms can detect when the heart is compromised by thickening of the pericardium.
Imaging tests such as CT scan, MRI or x-ray will help locate possible tumors or fluid buildup.
Then the physician typically will order a biopsy of tissue or fluid. Fluid biopsy (Effusion Cytology) involves a fluid removal procedure called pericardiocentesis. Fluid biopsy has a 20 percent success rate in correctly identifying the disease.
Most treatments are palliative, designed to ease pain and discomfort. Invasive treatments are more risky because of the close proximity of the heart.
Tumors cause inflammation, constriction, and irritation of the heart’s lining, Pericardiectomy removes all or part of the pericardium easing constriction and painful retention of fluid. The membrane is then reconstructed with Gortex, a breathable fabric.
A surgeon places a small catheter into the tissue surrounding the heart to help drain fluid from the pericardial sack.
Tumor growth can be slowed by chemotherapy, the most common cancer treatment, to ease symptoms and prolong life. One study found that combinations of the chemotherapy medications (vinorelbine, gemcitabine and cisplatin) stopped the advancement of tumor growth in one patient for two years.
Because of the extreme rarity of this disease, research is limited. Outcomes, longer than the average six months, are better for patients able to participate in clinical trials which also support needed research.
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