Pericardial mesothelioma is an extremely rare malignant mesothelioma that affects the lining that protects the heart. Like other types of malignant mesothelioma, , e.g., peritoneal mesothelioma, pleural mesothelioma, and testicular mesothelioma, pericardial mesothelioma is caused by exposure to toxic asbestos fibers, although how the fibers end up in the heart lining, or pericardial sac, is unknown. The prevailing theory is that the asbestos fibers are inhaled and travel through the bloodstream until they reach the heart, where they lodge in the spaces in the pericardial covering. So few cases are documented that the correlation between asbestos exposure and pericardial mesothelioma has not been verified with certainty, but a significant number of patients have confirmed exposure to asbestos, and all other types of malignant mesothelioma have been unquestionably linked to asbestos.
Several decades may pass before malignant mesothelioma tumors begin to develop and symptoms appear. Pericardial mesothelioma symptoms do not manifest until the end stages of the disease, and early detection is very unlikely. Generally, the only opportunity for early detection is another problem that requires careful examination of the heart. Even then, pericardial mesothelioma is unexpected, easy to miss, and difficult to identify.
When a patient is diagnosed with pericardial mesothelioma, the prognosis is almost always grim. The proximity to the heart, coupled with the average age of malignant mesothelioma patients – over 55 – and the advanced stage of the cancer, severely limits treatments and rules out most opportunities for surgery. By the time symptoms are evident, the average patient has six months or less to live.
Pericardial Mesothelioma Symptoms
Pericardial mesothelioma is the least common type of malignant mesothelioma, totaling about 5% of malignant mesothelioma cases. The following symptoms are common:
- Heart palpitations or irregular heartbeat (arrhythmia)
- Chest pain
- Heart murmurs
- Dry cough
- Difficulty drawing a breath, even at rest
- Orthopnea (struggling to breathe when lying down)
- Fatigue
- Fever
- Night sweats
How Pericardial Mesothelioma Symptoms Develop:
Pericardial mesothelioma attacks the protective sac that covers the heart, called the pericardium. The membrane that makes up the pericardium is made up of an inner and outer layer of mesothelial cells. These specialized cells secrete a fluid that acts as a lubricant to prevent friction as the organs move within the body.
The outer layer of the pericardium is the parietal layer, also known as the parietal sac. The inner layer is the visceral layer, also known as the epicardium. The outer parietal layer is part of the membrane that protects the entire chest cavity. The visceral layer surrounds only the heart.
When asbestos fibers lodge in the pericardial tissues, the cells eventually become inflamed. This causes the cells to swell and produce extra fluid. At the same time, malignant mesothelioma tumors begin to grow. Pericardial mesothelioma tumors are diffuse and tend to spread until they cover the entire heart. The excess fluid is trapped and puts pressure on the heart, which results in the symptoms.
Peritoneal mesothelioma is a form of malignant mesothelioma that affects the lining that protects the abdomen. Peritoneal mesothelioma develops many years after exposure to asbestos, a mineral that was commonly used in thousands of building and commercial products until the 1970s and is still in limited use in the United States and widespread use in many other countries today.
Peritoneal mesothelioma is the second most common type of mesothelioma, the other types being pleural mesothelioma, pericardian mesothelioma and testicular mesothelioma. About 20 percent of malignant mesothelioma cases diagnosed each year are peritoneal mesothelioma. Malignant mesothelioma is not common. An overwhelming number of patients develop pleural mesothelioma, making peritoneal mesothelioma a very rare diagnosis.
People are most often exposed to asbestos on the job. When the tiny fibers are disturbed, they float in the air and settle everywhere, including clothing, skin, food, and drink. Asbestos may be ingested when people breathe the tiny fibers in, cough them up and swallow, or when fibers are ingested with food or drinks.
After exposure to asbestos, nothing apparent may happen for up to 50 years. Over time, cancerous tumors form, grow and spread. The cells in the peritoneal tissue become inflamed and swell, closing the gaps in the lining that allow fluid to drain. Fluid builds up in the abdomen, which leads to most of the symptoms associated with peritoneal mesothelioma, a rare type of malignant mesothelioma.
Diagnosis of peritoneal mesothelioma is extremely difficult due to its rarity. Most doctors, except those who practice near certain types of mines and in areas populated mostly by industrial workers, might never see a case during their lifetimes. The symptoms are easily mistaken for less serious and more common ailments. It is often only after the symptoms prove to be resistant to treatment and persist that the doctor looks for other answers. Since an improper diagnosis can lead to delay of proper treatment, it is important for the patient to make sure that the doctor knows if he has been exposed to asbestos at any point during his life.
Peritoneal Mesothelioma Symptoms:
- Shortness of breath or difficulty breathing
- Coughing without signs of respiratory infection
- Pain in chest or abdomen
- The abdomen becomes swollen and taut (indicating fluid buildup)
- Unexplained weight loss of more than 10% of body weight
- Loss of appetite
- Sleeplessness
- Hoarse or husky voice
- Difficulty swallowing
How Peritoneal Mesothelioma Symptoms Develop:
Peritoneal mesothelioma attacks the protective membrane that covers the abdomen and organs. There are two layers of the lining, the parietal peritoneum and the visceral peritoneum. The parietal peritoneum covers the abdominal cavity, extending to cover the heart and lungs. The visceral peritoneum protects the upper part of the intestinal tract and the internal organs.
The linings are made up of cells that function as lubricators, secreting fluid that allows the organs and linings to rub against each other and move without friction. The symptoms of peritoneal mesothelioma appear when the inflamed cells overproduce fluid and tumors cover the peritoneum, preventing drainage. The abdominal cavity fills with fluid, putting pressure on all the internal organs, the belly visibly swells and feels taut, and the lungs are squeezed and unable to expand enough to draw a full breath.
Early Stages of Malignant Mesothelioma:
In the early stages of malignant mesothelioma, there may be no detectable symptoms. The cancer itself is painless and develops slowly over a long period of time. This makes it very difficult to detect without extensive testing, and many victims are unaware they were at risk. Malignant mesothelioma is usually a result of exposure to asbestos that happened years, or even decades, before. It is thought to be caused by prolonged exposure, most commonly in a work environment, but it is unknown whether any level of exposure to asbestos can be considered safe.
Symptoms develop in the late stages of the cancer, when the tumors grow large enough to put pressure on a nerve or other body organ, or block the flow of air to the lungs. One reason for the relatively low survival rate of malignant mesothelioma patients is that by the time the symptoms manifest, it is often too late to help the patient.
The most common types of malignant mesothelioma are pleural mesothelioma (lung) or peritoneal mesothelioma (abdomen). The symptoms of these cancers can be attributed to other causes, but if you have any of these symptoms, see a physician, and have tests run. Make sure your doctor knows if you have been exposed to asbestos in the past to help him pinpoint or rule out the problem.
Early Detection:
There is no reliable method of early detection today. Malignant mesothelioma is rare and difficult to detect. For people with known exposure, many doctors recommend regular chest X-rays or CT scans to track lung changes that might indicate signs of malignant mesothelioma or other lung cancers, but it is unknown how reliable these tests are in finding early malignancy.
Recent research efforts reveal that people with malignant mesothelioma may have certain markers that can be detected with a blood test. Indicators such as elevated levels of osteopontin and soluble mesothelin-related peptides may one day be used as a screening tool, but are currently being used only to monitor patients already diagnosed with malignant mesothelioma for research purposes.
Symptoms of Late-Stage Pleural Mesothelioma:
- Pain in the lower back or the side of the chest
- Persistent coughing
- Shortness of breath
- Profound muscle weakness
- Hoarse voice
- Unexplained weight loss higher than 10% of your weight
- Sweating and fevers
- Trouble swallowing
- Swelling of the face and arms
- In very rare cases, some people experience changes in the shape of their fingers and nails called finger clubbing
Symptoms of Late-Stage Peritoneal Mesothelioma:
- Abdominal (stomach) pain
- Swelling or fluid in the abdomen that cases bulging
- Unexplained weight loss higher than 10% of your weight
- Nausea and vomiting
If you have any of these symptoms do not jump to conclusions. Many of these symptoms are also associated with other common, and often temporary, ailments like allergic reactions, pneumonia, flu, or food poisoning. Consult with your doctor to determine what’s really going on.
People at Risk for Malignant Mesothelioma
Typical occupations most at risk for asbestos exposure are shipyard workers, automobile factory and repair workers, Navy personnel, construction workers, mine workers, heavy machine operators, and people who work with air conditioning and heating systems. Since asbestos dust sticks to clothing, the families of these workers are also at risk. People who live near mines are at greatest risk. Your doctor should know if you were ever at risk of asbestos exposure even if you have no reason to suspect asbestos cancer, malignant mesothelioma or another related disease, asbestosis.
While asbestos was commonly used in nearly everything built before the late 1970s, people who live in houses with asbestos tiles or insulation are not generally at risk. Most asbestos is bound to another material and can not float in the air to be inhaled. The danger is during manufacturing and mining, when materials are sawn or ground, filling the air with deadly asbestos dust. If you have an old house you wish to remodel, it’s best to hire a professional hazardous materials certified contractor to handle the repairs. Few people under the age of 30 in the United States are at risk for asbestos cancer or malignant mesothelioma today. Between 1940 and 1970, when asbestos was heavily in use, approximately 27.5 million people were exposed to toxic asbestos fibers at work.
Malignant mesothelioma is a deadly disease that primarily attacks the lining of the lungs or the stomach. There is no cure for malignant mesothelioma, and the prognosis for most people diagnosed with the disease is not good. Since no effective early detection screening or test exists and mesothelioma has no symptoms, most people are not diagnosed until they are in the late stages of the disease. On average, 2,500 new cases of malignant mesothelioma are diagnosed each year in the United States, with 43,000 cases diagnosed worldwide.
Cause of Malignant Mesothelioma
Malignant mesothelioma is caused almost exclusively by exposure to asbestos. Asbestos is the name for a group of minerals that occur naturally as tiny bundles of fibrous threads. Because asbestos is strong, lightweight, fireproof, resistant to chemicals, and non-conductive to heat or electricity, it became a very popular construction material beginning in the late 1800s. It was included in roofing materials, siding, flooring, insulation, automobile brakes, and many other common household products and materials. When asbestos fibers are inhaled, they stick to the lining of the lungs, the stomach, the heart, or the testicles and over a long period of time, cancerous tumors develop.
Who is at high Risk?
Most of the people who develop malignant mesothelioma have worked in an industry that depends heavily on the material without safety precautions. At-risk occupations include shipyard workers, automobile factory and repair workers, Navy personnel, construction workers, mine workers, heavy machine operators, and people who work with air conditioning and heating systems. Also at risk are people who live with workers in these occupations and people who live near mining operations in areas where asbestos is common. The former W.R. Grace vermiculite mine in Libby, Montana is one of the most contaminated sites in the country. Asbestos dust filled the air for decades during the mining process for vermiculite. People who lived in Manhattan during and after the 9/11 terrorist attacks may be at risk in the future. The attack threw tons of asbestos-laden dust into the air. Malignant mesothelioma can take 50 years to develop after exposure, so only time will tell how many people were affected.
Types of Malignant Mesothelioma:
There are four types of malignant mesothelioma.
Pleural mesothelioma is the most common type of malignant mesothelioma, comprising about 75% of cases. It develops in the pleura, or lining of the lungs.
Peritoneal mesothelioma accounts for approximately 20% of malignant mesothelioma cases. It develops in the peritoneal membrane, which is the lining of the abdominal cavity.
Pericardial mesothelioma develops in the pericardium or the lining of the heart and accounts for only about 5% of all mesothelioma cases.
Testicular mesothelioma affects the tunica vaginalis of the testicles and is the rarest form of malignant mesothelioma.
Malignant Mesothelioma Diagnosis
There are currently no reliable tools, scans, or tests for early detection of malignant mesothelioma. Before the disease reaches the late stages, it is virtually undetectable by any means. Current research is very encouraging, though. Within a few years, we may see a blood test on the market that can find substances in the blood common to patients diagnosed with malignant mesothelioma. These tests, currently being used to monitor changes in patients who have already been diagnosed, may hold the answer to early detection.
Malignant Mesothelioma Symptoms:
The symptoms of malignant mesothelioma only manifest after the tumors are developed enough to put pressure on other organs and cause swelling and fluid retention.
Pleural (lung) mesothelioma patients can expect shortness of breath, coughing, unexplained weight loss, trouble swallowing, hoarseness, muscle weakness, swelling of the arms and face, and pain in the lower back or side.
Peritoneal (abdomen) mesothelioma patients might experience stomach pain, a distended, tight abdomen, unexplained weight loss or nausea and vomiting.
Pericardial (heart) mesothelioma patients could have arrhythmia (irregular heartbeats), chest pains, persistent cough, difficulty breathing, fatigue, fever, or night sweats.
Testicular mesothelioma manifests as lumps on the testicles or swelling of the scrotum.
Most of the symptoms mentioned above may be indications of a number of other diseases or conditions. If you experience any of these symptoms, see a doctor. If you are aware of asbestos exposure, even from many decades in the past, let your doctor know.
Malignant Mesothelioma Treatment
There are many different treatments and kinds of therapy available today for malignant mesothelioma. The plan of action is decided by the doctor and the patient, and may include surgery, chemotherapy, drugs, radiation, or gene therapy. Factors that influence the course of treatment for malignant mesotheliomainclude the age and overall health of the patient.
Positive results from recent clinical studies involving immunotherapy and photodynamic therapy may prove beneficial for malignant mesothelioma treatments in the near future. Other clinical trials are exploring combinations of various chemotherapy drugs, medications, and dietary supplements
