Pericardial mesothelioma is a cancer found in the membranes surrounding the heart. The pericardial membrane of the heart consists of two layers. The outer layer is called the parietal pericardium and the inner layer is called the visceral pericardium.
Pericardial mesothelioma is the rarest kind of mesothelioma that is known to us. Almost all kinds of mesotheliomas can indirectly be traced back to asbestos exposure in any form.
Pericardial mesothelioma is twice as common in men when compared to women. It is usually diagnosed between the ages of 50 and 70 years. This disease can take many years to develop. The average duration for mesothelioma detection after asbestos exposure is five to ten years.
Pericardial mesothelioma is usually discovered in the later stages of the disease
Pericardial Mesothelioma Diagnosis
The clinical presentation of the symptoms is not always apparent when the cancer is at its early stages. The fact that the symptoms resemble those of heart disease makes this a difficult cancer to diagnose early. Most of the symptoms are caused by a build-up of fluid and thickening of both the layers of the pericardial membrane.
Symptoms of fatigue, chest pain and shortness of breath can resemble many other disease conditions, making this a very difficult diagnosis.
The following symptoms may suggest Pericardial Mesothelioma:
- Palpitations or irregular heart beat
- Chest pain
- Heart Murmurs
- Difficulty breathing, even at rest
- Orthopnea ( difficulty breathing when lying down)
- Fever or night sweats
3 Methods Of Diagnosing Pericardial Mesothelioma
In order to diagnose a patient with Pericardial mesothelioma, the symptoms, medical history and current medical condition must be assessed cumulatively. Various imaging tests like Xrays or CT can help see where it is located.
1) Computed tomography: CT is the preferred diagnostic tool because it can help locate exactly where the mesothelioma is located on the heart. The pericardial mesothelioma is usually generalized and tends to cover most of the heart. MRIs can also be useful in this regard to locate the tumor on the heart.
2) Radionucleotide imaging: This involves an injection of a radioactive material to detect cancer cells. It is not a commonly used method of testing but radiogallium has been used to detect one such cancer.
3) Biopsy: This can be a more suitable method to determine the site of origin of a pericardial mesothelioma. This will involve removing the tissue with the help of a needle and examining the tissue under a microscope in the laboratory.
Pericardial Mesothelioma Prognosis
Between 10 – 20% of pericardial mesothelioma cases are diagnosed before the patient dies. On the contrary, 80-90% of diagnoses of Pericardial mesothelioma is made at an autopsy.
The delay in diagnosis is due to the late presentation of symptoms and the rarity of cases that develop in a case of pericardial mesothelioma. 50-60 % patients do not survive for more than six months following the diagnosis.
Pericardial Mesothelioma Treatment
The treatment options are limited because it lies so close to the heart, any surgical intervention risks damaging the heart tissue itself. Although most patients suffering from pericardial mesothelioma are not ideal candidates for surgery, it is the best way to treat this condition. In rare situations when the cancer is detected earlier when it is smaller, surgery can be an effective cure.
What Is A Pericardiectomy?
If the patient is a good candidate for surgical removal, he will be prepared for a pericardiectomy. This procedure involves removing part or all of the pericardial membrane surrounding the heart. This relieves the pressure on the heart and avoids fluid build up to ensure proper contraction of the heart.
What Is A Pericardiocentesis?
On the contrary, a pericardiocentesis can be performed as a palliative solution to remove the fluid around the heart that is obstructing its contractile ability. Fine needle aspiration can also be used to remove the fluid around the heart. Pain management is also a crucial part of palliative care for this cancer.
The effectiveness of chemotherapy or radiation therapy for life expectancy is minimal.
A Diagnosis Of Pericardial Mesothelioma
Make sure you get a second opinion as Pericardial mesothelioma is often mistaken for more common heart illnesses such as, Heart failure, Coronary heart disease, Tuberculosis pericarditis, Constrictive pericarditis,Cardiac tamponade
etc. An early and accurate diagnosis gives you access to a wider range of treatment options, and may also lead to improved survival rates.