Cancer-Related Heart Disease
Primary Heart Tumors
- Tumors that originate in the heart are called primary heart tumors. These are very rare.
- Primary heart tumors may develop in any of the heart tissues.
- The most common primary heart tumors are sarcomas — cancers that develop from blood vessel tissue.
- Half of all primary heart tumors are myxomas, noncancerous tumors that usually are irregular in shape and jellylike in consistency.
- Three-quarters of myxomas occur in the left atrium. Some of these myxomas run in families.
- Myxomas typically develop in young men in their mid 20s. Myxomas that are not hereditary usually develop in women between the ages of 40 and 60.
Secondary Heart Tumors
- Secondary heart tumors are those that originate in other parts of the body — most often the lungs, breasts, blood or skin — and spread (metastasize) to the heart.
- Secondary heart tumors are always cancerous.
- Secondary heart tumors are 30 to 40 times more common than primary heart tumors, but are still rare.
- Cancer metastasizes to the heart in about 10 percent of lung or breast cancer cases, and about 75 percent of malignant melanoma cases (a form of cancer that often arises in the skin).
- Secondary cancers spread by direct invasion of the pericardium — the sac that surrounds the heart — or through the bloodstream or lymph system.
Relationship Between Heart Disease and Cancer
Some cancer treatments, including chemotherapy and radiation, can also cause heart disease or a weakening of the heart muscle called cardiomyopathy (see heart failure). Another heart condition, cardiac amyloidosis, is sometimes linked to multiple myeloma.
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Signs and Symptoms
The symptoms of cancerous and noncancerous heart tumors are the same, but vary depending on the location of the tumor. However, the symptoms of cancerous heart tumors can worsen more quickly, as these tumors grow more quickly. Symptoms may include:
- Heart failure
- Hemoptysis (coughing up blood)
- Heart murmurs
- Weight loss
Other Signs of Heart Tumors
- Primary tumors may spread to the spine, nearby tissues or organs such as the lungs or brain.
- Myxomas grow from a stalk and may swing back and forth with the flow of blood, blocking the mitral valve, causing blood flow to stop and start intermittently. This may cause fainting, shortness of breath or fever.
- Myxomas may degenerate so that pieces of them break off and travel through the bloodstream, turning into blood clots that block blood flow.
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Diagnosis of Heart Tumors
- Primary heart tumors are difficult to diagnose because they are so rare. They may be suspected, though, in those who are having heart murmurs, arrhythmias, unexplained fevers or unexplained symptoms of heart failure.
- Secondary heart tumors are suspected when people who have cancer in other places in the body are exhibiting symptoms of heart disorders.
Heart tumors can be detected by any of the following tests:
Computed Tomography (CT) Scan
This test delivers computer-generated, x-ray images of structures inside the body.
Magnetic Resonance Imaging (MRI) Scan
MRI uses magnets and radio waves to make images of the inside of your body.
This test uses sound waves to create a moving picture of the heart. The picture is much more detailed than x-ray image and involves no radiation exposure.
A test in which a thin tube called a catheter is snaked into a blood vessel and a contrast due is injected to make the vessels visible on x-ray.
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Treatment for Heart Tumors
A single, small noncancerous primary heart tumor, including myxomas, can be surgically removed, usually resulting in a cure.
Chemotherapy or Radiation
Primary or secondary cancerous tumors that cannot be surgically removed are often fatal. Treatment is designed to reduce symptoms and may include chemotherapy or radiation.
If tumors in the pericardium cause fluid to accumulate around the heart, that fluid may be drained.
Heart Disease Secondary to Cancer Treatments
Some cancer treatments may cause damage to the heart, such as cardiomyopathy or weakening of the heart muscle or can cause a heart attack from spasm or narrowing of the arteries that deliver blood to the heart.
Some experts recommend that cancer patients, particularly breast cancer patients, get a formal heart risk assessment before their cancer treatment regimen is decided.
Some chemotherapy regimens can also increase the risk of cardiomyopathy or heart attack. Some commonly used breast cancer drugs, Adriamycin and Herceptin, can sometimes cause weakening of the heart muscle.
Radiation, particularly to an area of the body that includes the heart, can also increase the risk of cardiomyopathy and heart attack.
Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue, which make it hard for the heart to work properly. It is often seen in patients with multiple myeloma. Cardiac amyloidosis occurs when these deposits take the place of normal heart muscle. The condition may be treated with chemotherapy or anti-inflammatory medications.
Cardiac amyloidosis may also affect the way electrical signals move through the heart, leading to arrhythmias. These abnormal rhythms may be treated with medications and a pacemaker.
Eventually, however, the heart muscle fails. Patients with this condition rarely live longer than one to two years.
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