Medicine:Heart cancer

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Heart cancer
SpecialtyOncology, Cardiology

Heart cancer is an extremely rare form of cancer that is divided into primary tumors of the heart and secondary tumors of the heart.

Types

Primary

Most heart tumors begin with myxomas, fibromas, rhabdomyomas, and hamartomas, although malignant sarcomas (such as angiosarcoma or cardiac sarcoma) have been known to occur. In a study of 12,487 autopsies performed in Hong Kong seven cardiac tumors were found, most of which were benign.[1] According to Mayo Clinic: "At Mayo Clinic, on average only one case of heart cancer is seen each year."[1] In a study conducted in the Hospital of the Medical University of Vienna 113 primary cardiac tumour cases were identified in a time period of 15 years with 11 being malignant. The mean survival in the latter group of patients was found to be 26.2 ± 9.8 months.[2]

Primary malignant cardiac tumors (PMCTs) are even rarer. The most recent published study about PMCTs used the Surveillance, Epidemiology and End-Results (SEER) Cancer Registry to study 497 patients with PMCTs who were diagnosed during 2000–2001 in the United States. Most cases were angiosarcomas (27.3%) with an incidence of 0.107 per 1,000,000 person-years and Non-Hodgkin's lymphomas [NHL] (26.9%), with an incidence of 0.108 per 1,000,000 person-years. The incidence rate of NHL increased significantly over the study period, but the incidence of cardiac angiosarcomas did not. The overall survival of NHL was found to be significantly better than angiosarcomas.[3]

Another previous study using the Surveillance, Epidemiology and End-Results (SEER) Cancer Registry from 1973 to 2011 found 551 cases of PMCTs, with an incidence of 34 cases per million persons. The study also found that the incidence has doubled over the past four decades. The associated mortality was very high, with only 46% of patients alive after one year. Sarcomas and mesotheliomas had the worst survival, while lymphomas had better survival. When compared with extracardiac tumors, PMCTs had worse survival.[4]

Secondary

Secondary or metastatic heart tumours are much more common than primary heart tumours, occurring even 100 times more often.[5] Every tumour in theory can metastasize to the heart with the only exception being tumours of the central nervous system.[6] Malignant melanomas frequently metastasize to the heart, and represent the tumour with the highest rate of cardiac metastases (in more than half of cases).[7]

Signs and symptoms

Patients with heart tumours usually have non-specific symptoms, such as dyspnea (in particular, shortness of breath when lying down), thoracoabdominal pain (pain in the general area around the heart), fatigue, hemoptysis, nausea and vomiting, fever, weight loss, and night sweats. These symptoms mimic symptoms of other heart diseases, which can make diagnosis difficult.[citation needed]

Diagnosis

In most cases, the diagnosis is based on clinical history, echocardiography, a CT scan or an MRI scan.[8] Cardiac tumours are often first diagnosed after the patient has had a stroke, an embolism caused by detached tumour tissue.[9]

Treatment

Primary tumours

Benign tumors

Most of these can be cured if the tumor can be completely removed. When a tumor is very large or there are multiple tumors, removing part of it that is not inside the heart walls can improve or eliminate symptoms. Some types can be followed with yearly echocardiograms instead of surgery if they are no longer causing symptoms.

Malignant tumors

Because they grow rapidly and invade important heart structures, they can be very difficult to treat. Unfortunately, most are not found until surgical removal is no longer possible. Chemotherapy and radiation therapy are sometimes used to try to slow tumor growth and improve symptoms (palliative care), but frequently they are ineffective for primary heart cancer.

Secondary tumours

In most cases, patients with heart metastases have advanced tumour disease, with the heart being only one of the many places involved in the generalised tumour spread. At that stage of the disease, the patients will likely have already undergone extensive chemotherapy, radiation therapy or surgical procedures. Cardiac treatment is usually confined to palliative measures.[6]

Notable cases

  • Henry VIII's first wife Catherine of Aragon's death is believed to have resulted from heart cancer.[10][self-published source?]
  • Eric Carr, American musician; drummer of the rock band Kiss, died of heart cancer.[11]
  • Alexander Belov, Soviet basketball player.[12]
  • Mimi Lerner, Polish-American mezzo-soprano, died of heart tumor.[13]
  • Ondřej Buchtela, Czech professional ice hockey defenceman, sarcoma of the heart muscle.[14]
  • Virgil Abloh, artistic director for Louis Vuitton and founder of fashion label Off White died of cardiac angiosarcoma.[15]

See also

  • Primary tumors of the heart

References

  1. ↑ 1.0 1.1 Moynihan, Timothy J. (2015-03-25). "Heart cancer: Is there such a thing?". http://www.mayoclinic.org/heart-cancer/expert-answers/faq-20058130. 
  2. ↑ "Primary cardiac tumors on the verge of oblivion: a European experience over 15 years". Journal of Cardiothoracic Surgery 10: 56. April 2015. doi:10.1186/s13019-015-0255-4. PMID 25928192. 
  3. ↑ "Characteristics, survival and incidence rates and trends of primary cardiac malignancies in the United States". Cardiovascular Pathology 33: 27–31. December 2017. doi:10.1016/j.carpath.2017.12.001. PMID 29414429. 
  4. ↑ "Characteristics and Survival of Malignant Cardiac Tumors: A 40-Year Analysis of >500 Patients". Circulation 132 (25): 2395–402. December 2015. doi:10.1161/CIRCULATIONAHA.115.016418. PMID 26467256. 
  5. ↑ Burke A, Virmani R. Tumors of the Cardiovascular System, Atlas of Tumour Pathology, 3rd Series, Fascicle 16. Washington, DC: Armed Forces Institute of Pathology 1996
  6. ↑ 6.0 6.1 Reynen, K. (2004-03-01). "Metastases to the heart" (in en). Annals of Oncology 15 (3): 375–381. doi:10.1093/annonc/mdh086. ISSN 0923-7534. PMID 14998838. 
  7. ↑ Glancy, D.Luke; Roberts, William C. (1968-04-01). "The heart in malignant melanoma: A study of 70 autopsy cases" (in en). The American Journal of Cardiology 21 (4): 555–571. doi:10.1016/0002-9149(68)90289-0. ISSN 0002-9149. PMID 5650736. 
  8. ↑ Kumar, Manish; Tigadi, Supriya; Azrin, Michael A.; Kim, Agnes S. (2019-05-21). "Multimodality Imaging of a Right Atrial Cardiac Mass". Cureus 11 (5): e4705. doi:10.7759/cureus.4705. ISSN 2168-8184. PMID 31355065. 
  9. ↑ "Cardiac tumors--diagnosis and surgical treatment". Deutsches Ärzteblatt International 111 (12): 205–11. March 2014. doi:10.3238/arztebl.2014.0205. PMID 24717305. 
  10. ↑ Lehman, H. Eugene (2011). Lives of England's Reigning and Consort Queens. AuthorHouse Publishing. pp. 294. ISBN 978-1-4634-3057-3. 
  11. ↑ Wilkening, Matthew (24 November 2015). "The Day Kiss Drummer Eric Carr Died" (in en). https://ultimateclassicrock.com/kiss-drummer-eric-carr-died-twenty-years-ago-today/. 
  12. ↑ "The Free Lance-Star – Google News Archive Search". https://news.google.com/newspapers?nid=1298&dat=19781005&id=Ot5NAAAAIBAJ&sjid=8ooDAAAAIBAJ&pg=6493,498794. 
  13. ↑ Heydarpour, Roja (2007-04-14). "Mimi Lerner, 61, Opera Singer With an Unconventional Career, Dies" (in en-US). The New York Times. ISSN 0362-4331. https://www.nytimes.com/2007/04/14/obituaries/14lerner.html. 
  14. ↑ "Zemřel Ondřej Buchtela". 24 July 2020. https://hokejbenatky.cz/clanek.asp?id=Zemrel-Ondrej-Buchtela-3330. 
  15. ↑ "Virgil Abloh, fashion designer behind Off-White and Louis Vuitton, dies of cancer at 41". November 28, 2021. https://www.cbc.ca/news/entertainment/virgil-abloh-obit-louis-vuitton-1.6265935. 

External links

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