Pericardial Mesothelioma: Diagnosis
Pericardial mesothelioma is an extremely rare form of cancer, with no symptoms until the end stages. The overwhelming majority of doctors will never encounter a case of pericardial mesothelioma within their lifetimes. Symptoms appear only after the heart is virtually covered by tumors and the cancer is running rampant. As a result, by the time the symptoms are apparent and diagnosis is possible, the prognosis—or life expectancy and number of available treatment options—is grim. On average, a patient diagnosed with pericardial mesothelioma—a cancer that affects the lining of the heart—is six months or less.
Pericardial mesothelioma is a difficult cancer to pinpoint because the symptoms are the same as many types of common heart problems. Heart disease accounts for several of the most common fatal illnesses in the United States. When a patient describes symptoms of pericardial mesothelioma, he is most likely to be tested for a heart condition long before malignant mesothelioma is suspected. However, once symptoms are present, there is little that can be done. Pericardial mesothelioma is inoperable, and there is no cure. Treatment focus will be on palliative care to make the patient as comfortable as possible during the last stages of his life.
This type of malignant mesothelioma is nearly impossible to detect early. The tumors are small and widespread, covering the surface of the pericardial tissue surrounding the heart. By the time the tumors grow large enough to be detected by an X-ray or CT scan, they cannot be removed with surgery.
Screening procedures exist for many other types of cancers and pulmonary disease, like prostate exams and heart stress tests. No screening exists today that can detect pericardial mesothelioma in its early stages.
Testing for Pericardial Mesothelioma
Diagnosis is usually a result of a doctor visit after the patient starts to experience the symptoms that signify late stage pericardial mesothelioma. These symptoms—like heart palpitations, irregular heartbeat, or chest pains—are easily mistaken for other types of heart problems, which can delay an accurate pericardial mesothelioma diagnosis. The doctor may send the patient to a heart specialist immediately, who will perform a series of tests designed to narrow down the diagnosis. These tests may include heart stress tests, cholesterol and triglyceride screenings, and blood pressure readings, followed by X-rays, CT scans, and biopsy procedures. Most of these tests are unlikely to indicate pericardial mesothelioma, as the only reliable indicator is the biopsy.
The Results
Pericardial mesothelioma testing takes time, often weeks or even months. For patients experiencing heart problems, the waiting period can be filled with fear and anxiety, but there is little the doctor can do to speed the process. When the diagnosis of pericardial mesothelioma is confirmed, the patient sits down with the oncologist to discuss the prognosis and treatment options. Most pericardial patients will hear a shocking pronouncement that they have less than six months to live. Treatment options are often limited to palliative care—measures taken to make the patient comfortable, and manage pain, depression, anxiety, and spiritual issues. Arrangements may be made to drain the fluid from around the heart to allow easier breathing and ease the pain, and medications may be prescribed for pain and to help the patient sleep. Counseling is usually offered along with educational sessions to help the patient and his family to adjust to the difficult realities of this terminal disease and end-of-life care.
