Overview of cardiac sarcoma
Cardiac sarcoma is a rare type of primary malignant (cancerous) tumour that occurs in the heart. A primary cardiac tumour starts in the heart. A secondary cardiac tumour starts somewhere else in the body and then spreads to the heart. In general, primary tumours of the heart are rare, and most are benign (noncancerous).
What are the symptoms of cardiac sarcoma?
Symptoms of heart tumours vary depending on where the tumour is located. Tumours of the heart can be on the outer surface of the heart. They can be within one or more chambers of the heart (intracavitary) Or they may be within the heart muscle tissue.
Cardiac sarcomas are usually a type of sarcoma called angiosarcoma. Most angiosarcomas occur in the upper right chamber (atrium) of the heart. The tumour blocks blood flow in and out of the cavity. This blockage can cause symptoms such as chest pain and swelling of the feet, legs, ankles, or belly (abdomen). It can make the veins in your neck stand out (distend). This is because the blood that returns to the heart after travelling through the body cannot easily enter or exit the right atrium.
Tiny pieces (emboli) of cardiac sarcomas may break off and travel through the blood to other parts of the body. The tiny pieces may block blood flow to an organ or body part. This can cause pain and damage to that organ or body part. The tiny pieces can affect the brain by causing a stroke. Or they can affect the lungs by causing shortness of breath.
Other symptoms can include coughing up blood (hemoptysis), heart rhythm problems, hoarse voice, and swelling in the face. Signs of cardiac sarcoma not related to where the tumour is in the heart may include fever, weight loss, night sweats, fatigue, and a general feeling of not being well.
The symptoms of cardiac sarcoma often seem like other health conditions. It’s important to see a healthcare provider if you have symptoms. Only a healthcare provider can tell if you have cancer or some other problem that needs to be treated.
Diagnosis of cardiac sarcoma
The methods for diagnosing cardiac sarcoma vary, to some degree, on the symptoms present. Although, echocardiography has become the most useful tool in the diagnosis of cardiac sarcoma, allowing the physician to see the exact size and location of the tumour.
In addition to a complete medical history and physical exam, diagnostic procedures for cardiac sarcoma may contain the following:
- Echocardiogram (also known as echo)
- Electrocardiogram (ECG or EKG)
- Computed tomography (also called CT or CAT scan)
- Magnetic resonance imaging (MRI)
- Chest x-ray
- Cardiac catheterization
Cardiac sarcoma treatment
Specific treatment for cardiac sarcoma will be determined by your doctor based on:
- Your age, general health, and medical history.
- The extent and location of the disease.
- Your tolerance for specific medications, procedures, or therapies.
- Expectations for the course of the disease.
- Your opinion or preference
Once a cardiac sarcoma has progressed to the point where symptoms begin to appear, it has often spread to other parts of the body, making treatment difficult. The type of treatment for cardiac sarcoma largely depends on the location and size of the tumour, as well as the extent of the metastasis.
Open heart surgery
The doctor may determine that the tumour can be removed using an open-heart surgical procedure. However, this is often difficult due to the location of the tumour.
In some cases, the sarcoma has invaded the heart to such an extent that it is impossible to completely remove it. In this situation, a heart transplant has been attempted. However, a patient must be given immunosuppressive drugs after transplantation. This medicine can stimulate the new growth of sarcoma.
An exciting new prospect for the treatment of cardiac sarcoma is autotransplantation. During this surgical procedure, the patient’s own heart is removed so that the tumour can be more completely and easily removed from the heart tissue. The patient is placed on a heart-lung bypass machine during the surgery. After the tumour is removed, the heart is returned to the patient’s body. Because the patient has not received a heart from another person, there is no need for immunosuppressive medications. New drug treatments are also being studied, which may be available through clinical trials.
In some cases, such as when cancer has spread to other parts of the body, radiation therapy or chemotherapy may be given to help relieve symptoms or to improve a person’s quality of life.