Pericardial mesothelioma is a type of mesothelioma cancer that affects the pericardium, the membrane surrounding the heart. The pericardium, comprised of mesothelial cells, protects and supports the heart and consists of two layers. The parietal layer is the outer layer and is part of a large membrane that lines the chest cavity. The inner layer, known as the visceral layer, is smaller and lines the heart.
Pericardial mesothelioma is extremely rare, as approximately 1 to 6 percent of mesothelioma patients are diagnosed with this form of the cancer. Medical records indicate approximately 200 known cases of pericardial mesothelioma have been reported worldwide.
Pleural mesothelioma, the most common form of the cancer, is caused almost exclusively by asbestos exposure. While most cases of pleural mesothelioma can be attributed to exposure to the toxic mineral, the way asbestos causes pericardial mesothelioma is not well understood. This is largely due to the lack of research conducted on this rare form of the cancer. However, the link between asbestos exposure and pericardial mesothelioma exists as numerous patients with pericardial mesothelioma experienced asbestos exposure.
What is not understood is how the asbestos fibers reach the pericardial membrane, though once the fibers enter the area, they become lodged and cause inflammation and scarring. Overtime this causes inflammation and infection and the development of cancerous cells. The cells cause the pericardial membrane to thicken and tumors to develop which place pressure on the heart.
Patients with pericardial mesothelioma may not demonstrate symptoms of the cancer until decades after initial exposure to asbestos, which may make diagnosis difficult. Additionally, symptoms often resemble other heart conditions.
Pericardial mesothelioma symptoms include:
A pericardial mesothelioma diagnosis is typically reached after a patient experiences symptoms of the cancer and certain medical tests are performed. A doctor will usually begin the diagnostic process by reviewing a patient's symptoms and medical history and conducting a physical examination.
An imaging test, such as a chest X-ray or MRI will then likely be requested to determine the location of the cancer and examine whether or not it has spread to other areas of the body. A biopsy will then often be performed to test cells for the presence of mesothelioma.
Once a patient is diagnosed with pericardial mesothelioma, a doctor will typically refer the patient to an oncologist who specializes in the treatment of cancer. The doctor, together with the patient and their family, will determine the best possible course of treatment.
Surgery to remove the cancer is typically not an option for patients with pericardial mesothelioma, but if the cancer is diagnosed very early, it may be performed to attempt to remove cancerous tumors. Since the surgery occurs very close to the heart, it is often quite dangerous and not without serious risks.
Most pericardial mesothelioma patients will typically utilize palliative treatment options, designed to increase the quality of life and provide relief from pericardial mesothelioma symptoms. Removing fluid build-up is one such palliative treatment and radiation may also be an option for pericardial mesothelioma patients.
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