[breadcrumb]
Mesothelioma and Heart Failure
Malignant mesothelioma is a rare type of cancer affecting the tissues lining certain major organs. Pleural mesothelioma, the most common form of this cancer, does not seem to have a direct connection to heart failure or myocardial infarctions (heart attacks). However, surgery and treatments like radiation therapy can introduce new heart-related symptoms or worsen existing ones. Furthermore, pericardial mesothelioma — the rarest form of mesothelioma — can cause tumors to grow directly upon or within the heart, leading to a high risk of death from heart failure.
The majority of patients who develop malignant mesothelioma have a history of prior asbestos exposure[1]. Over 90% of mesothelioma cases involve primary origination of tumors in the pleura, a lining covering the lungs[2].
Pericardial mesothelioma, which affects the heart, occurs in just 1% of primary mesothelioma cases. However, 29% of pleural mesotheliomas that metastasize can affect the heart’s pericardium by the time the patient reaches the fatal stages of malignancy[3].
Patients suffering from pericardial mesothelioma can be at a high risk of abnormalities that can contribute to the risk of heart failure. 86% of patients in one case review exhibited electrocardiographic abnormalities, including 60% who had an arrhythmia and 37% who had conduction abnormalities[4].
The prognosis for anyone diagnosed with pericardial mesothelioma is poor, with patients surviving an average of 3.5 months from the time of diagnosis[5]. Many patients experience cardiac failure[6] or a constricting of the heart.
Non-pericardial mesotheliomas may still have an elevated risk of causing heart failure as a result of treatments used. Some cancers, such as lymphoma and breast cancer, have a heart failure rate three times higher compared to those who have never had cancer[7].
Treatments like chemotherapy can target healthy cardiovascular cells and lead to an increased risk of heart failure, as can the toxicity sometimes produced by radiation therapy[8]. Mesothelioma patients who undergo radical resectioning or who have their mesothelium removed are also at an elevated risk of heart attacks or arrhythmia[9]. The complete removal of the pleura and affected lung has a particularly high association with such complications.
Patients who have an existing history of heart conditions, like elevated blood pressure or cholesterol, have an even higher risk of heart failure and other complications during cancer treatment[10]. Two or more co-occuring conditions can worsen the patient’s prognosis and add complexities that make management of symptoms more difficult.
In conclusion, pleural mesothelioma can have a distant effect on heart health, and treatment can potentially create complications that make heart failure more likely. Radiation or chemotherapy treatments in general can lead to cardiotoxicity that can have an adverse effect on heart health. Patients with the rare form of pericardial mesothelioma have the highest comparative risk of heart failure because of the condition’s direct effect on the heart.
[1] https://www.cancer.org/cancer/malignant-mesothelioma/causes-risks-prevention/what-causes.html
[2] https://www.pulmonologyadvisor.com/pulmonary-medicine/malignant-pleural-mesothelioma/article/660962/
[3] http://ascopubs.org/doi/abs/10.1200/JCO.2017.35.15_suppl.8556
[4] https://pubs.rsna.org/doi/full/10.1148/radiographics.21.2.g01mr15439
[5] http://www.onlinejacc.org/content/71/11_Supplement/A2374
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767997/
[7] https://www.cancer.gov/news-events/cancer-currents-blog/2018/increased-heart-failure-risk
[8] https://heart.bmj.com/content/105/1/6
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3741783/
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258909/
