Mesothelioma in and of itself is a misunderstood diagnosis. As a cancer that affects roughly 3,000 Americans per year, it is often mistakenly thought of as a type of lung cancer. In reality, mesothelioma is a cancer of the mesothelial lining that surrounds several organs, the lungs being the most common one. However, this cancer can also affect the lining of the abdomen, and in extremely rare cases, the heart and testes.
When mesothelioma affects the lining surrounding the heart it is called pericardial mesothelioma. This type of mesothelioma is so rare that it only affects between 10-15 Americans annually.
This month’s issue of the Journal of Thoracic Oncology featured a new paper about a study following a series of pericardial mesothelioma patients at one institution over the course of 11 years. This type of mesothelioma is so rare that only 12 patients were identified – a fact that makes research extremely difficult. Because of this, the findings of the study should be interpreted with caution.
The study penned by Michael Offin, MD, and colleagues at Memorial Sloan Kettering Cancer Center was just published in the Journal of Thoracic Oncology along with an accompanying editorial which helped us contextualize the findings.
The twelve patients were predominantly female, which is not consistent with other incidence data, and were significantly younger than pleural disease patients (a median of 51 vs. 75). Nine, or 75%, presented with epithelioid disease, which is typical for mesothelioma in general. Overall, patients who underwent trimodal treatment (surgery, chemotherapy, and radiation) lived a median of 70.3 months compared with 8.2 months for those patients who were not treated with all three types of therapies.
The editorial accompanying the article pointed out that the very nature of selecting surgical candidates which tends to favor younger and healthier individuals may have had an impact on such promising results, but they nevertheless praise the results as “notable.” In fact, the median survival for the entire cohort of patients, including those who did not undergo trimodal treatment, was 25.9 months, which when compared to the 2-6 months overall survival previously reported, is equally remarkable.
Authors of both articles concur that the promise in the treatment of pericardial mesothelioma, just as with other types of mesothelioma, lies in the multi-disciplinary treatment approach, meaning that patients benefit when treated at centers with extensive mesothelioma expertise in a variety of medical disciplines.
