Pericardial Mesothelioma

The following article on Pericardial mesothelioma will explain what this condition is, what causes Pericardial mesothelioma and the symptoms

Pericardial mesothelioma is a type of asbestos-related cancer that affects the lining that surrounds the heart muscle. Although this form of mesothelioma is sometimes referred to as lung cancer the cancer does not actually initially affect the lungs. Pericardial mesothelioma affects the pericardium, which is the medical term for the lining of the heart, and the serous membranes of the lungs.

Pericardial mesothelioma is caused by exposure to asbestos. Prolonged exposure to and inhalation of asbestos dust, which is created during the building, maintenance, and repair of items containing asbestos, is the only known cause of pericardial mesothelioma (5). However, it is not exactly understood how this asbestos dust, or the microscopic asbestos fibers that it carries, become trapped in the pericardium or membranes. One theory is that the asbestos fibers are broken down in the lungs and transferred through the bloodstream to the pericardium and serous membranes. With other types of mesothelioma the lymphatic system has been shown to aid in the transfer of asbestos fibers from one part of the body to another. This route could also explain the spread of fibers that cause pericardial mesothelioma (5).

Since the spread of fibers is more difficult to this area of the body pericardial mesothelioma is a very rare form of the disease. In fact, this type of asbestos cancer only accounts for 6% of all mesotheliomas (1).

Exposure to asbestos and asbestos dust does not immediately lead to mesothelioma. In fact, symptoms of the disease can take up to thirty years to first appear. That is why it is so important to understand the symptoms of pericardial mesothelioma if you have ever had any exposure to asbestos dust. A clear understanding of the symptoms and a knowledge of what to look for as early signs of the disease can increase the chances of early diagnosis and increase the probability of success treatment.

The symptoms of pericardial mesothelioma are similar to the symptoms seen with pleural mesothelioma and include shortness of breath, chest pain, persistent cough, heart palpitations, and extreme fatigue after light exertion or activity (2). Although it is best to recognize and document these symptoms early in the progression of pericardial mesothelioma, most of the symptoms do not occur until the disease has progressed into the later stages.

The symptoms of pericardial mesothelioma are not actually a direct consequence of the disease itself. Instead, symptoms such as shortness of breath, chest pain, and heart palpitations, are caused by the accumulation of fluid around the heart. The fluid is not a symptom of pericardial mesothelioma. Instead it is a by-product of the ever expanding cancerous tumor (1). As the pericardial mesothelioma grows in the lining of the heart it causes an expansion of the surrounding tissue. This expansion leads to a build up of excess fluid that puts pressure on the heart and surrounding organs like the lungs. This pressure is actually the cause of chest pain and shortness of breath. The swollen tissue also reduces the space allowed for inhaled air, thus reducing the oxygen available to the body. This reduced oxygen supply can cause extreme and early fatigue.

If anyone with a history of asbestos exposure begins suffering from the symptoms of pericardial mesothelioma it is imperative that they seek medical attention right away. A prompt and proper diagnosis is the first step in mesothelioma treatment. Once a diagnosis is made treatment options, such as surgery, can increase the individual’s long-term survival rate.

In order for a doctor to make an accurate diagnosis of pericardial mesothelioma many steps must be taken and numerous tests must be performed. Most medical professionals begin the diagnosis process with a full medical history. This history will include detailed questions about asbestos exposure, such as dates of exposure, circumstances of exposure, and the duration of asbestos exposure. The next step in pericardial mesothelioma testing is usually medical imaging. Most doctors begin with a traditional x-ray in order to obtain a general understanding of the health of the heart. From there doctors seek more detail with CT scans and MRIs. A biopsy, a procedure where a small needle is inserted into the affected tissue in order to withdraw a sample of the suspected mesothelioma, can be used to further confirm or deny the existence of mesothelioma in the lining of the heart (6).

Currently these tests are the only reliable methods available for detecting and diagnosing pericardial mesothelioma, or mesotheliomas of any kind. Current research, however, is focused on developing more accurate methods of testing. These diagnostic aids are meant to increase the chances of early detection and help prolong the lives of those diagnosed with pericardial mesothelioma (3).

Once an accurate diagnosis of pericardial mesothelomia has been made proper treatment can be started. However, it is important to understand that a cure for mesothelioma does not currently exist and that most treatment forms are focused instead on making the patient comfortable during the progression of the disease and at prolonging the life of the affected individual (6).

Treatment options for pericardial mesothelioma include surgery, radiation therapy, chemotherapy, and medication therapy. Surgery is usually not recommended for pericardial mesothelioma treatment unless the disease is caught in its very early stages when the procedure would be most effective. Radiation therapy, a procedure that employs high-energy radiation either in the form of an x-ray or radiation-emitting materials that are inserted into the affect area of the body, is used to kill the cancerous cells and shrink the size of the pericardial mesothelioma tumor. This type of therapy treatment has proven to be the most successful with this type of mesothelioma cancer and is usually one of the first treatments performed.

Chemotherapy, a procedure where drugs and chemicals are injected into the veins, is also used to target and kill cancer cells. This type of treatment is the second most common form used to treat pericardial mesothelioma but it also carries a high risk for unwanted side effects.

Another type of pericardial mesothelioma treatment involves the removal of fluids from the chest and abdominal areas. These procedures, thoracentesis and paracentesis, do not actually treat or cure the mesothelioma, instead they focus on relieving the pressure caused by fluid build up and relieving the pain and symptoms associated with this build up.

Current pericardial mesothelioma research is dedicated to finding new ways to treat and cure this form of cancer. IMRT (Instensity Modulated Radiation Therapy), PDT (Photodynamic Therpay), gene therapy, biological therapy, and new drugs such as Veglin and Alimta are showing promising results and are offering new hope for people diagnosed with pericardial mesothelioma (4).

Pericardial mesothelioma is a rare and deadly disease that is directly linked with asbestos exposure. The biggest chance of survival lies in early detection so everyone who has been exposed to asbestos dust is encouraged to seek regular medial check-ups and legal advice.

‘Pericardial Mesothelioma’ Resources:

Warren WH: The clinical manifestations and diagnosis of mesothelioma. In Mesothelioma: Diagnosis and Management. Edited by Kittle CF. Chicago: Year Book; 1987: 31.

Pass HI: Emerging translational therapies for mesothelioma. Chest 1999, 116:455S-460S. Quinn DW: Pericardial mesothelioma: the diagnostic dilemma of misleading images. Ann Thorac Surg 2000, 69:1926-1927.

Watanabe A, et al.: Primary pericardial mesothelioma presenting as constrictive pericarditis: a case report. Jpn Circ J 2000, 64:385-388.

Dodson RF, et al.: Analysis of asbestos fiber burden in lung tissue from mesothelioma patients. Ultrastruct Pathol 1997, 21:321-336. Kralstein J: Malignant pericardial diseases: diagnosis and treatment. Am Heart J 1987, 113:785-790.

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