Heart Cancer

• Primary heart cancer, originating in the heart, is extremely rare, with secondary (metastatic) cancers being far more common.
• Symptoms are often non-specific, mimicking other heart conditions, and can include breathlessness, chest pain, and fatigue.
• The exact causes of heart cancer are often unknown for primary tumors, while secondary tumors result from cancer spreading from other organs.
• Heart cancer treatment options vary widely depending on the tumor type, stage, and whether it’s primary or secondary.
• Diagnosis typically involves imaging tests like echocardiograms, CT scans, and MRIs, often followed by a biopsy.

Understanding What is Heart Cancer

What is Heart Cancer? It is a malignant growth that originates in or spreads to the heart. Primary heart cancer, meaning the cancer starts in the heart itself, is exceptionally rare. According to a review published in the journal “Circulation,” primary cardiac tumors are found in less than 0.02% of autopsies, with only a fraction of these being malignant. These primary tumors can include sarcomas (such as angiosarcomas, rhabdomyosarcomas, and leiomyosarcomas), lymphomas, and mesotheliomas.

Far more common are secondary, or metastatic, heart cancers. These occur when cancer from another part of the body spreads to the heart. Cancers that frequently metastasize to the heart include lung cancer, breast cancer, melanoma, lymphomas, and leukemias. Metastatic heart tumors are estimated to be 20 to 40 times more prevalent than primary cardiac malignancies, highlighting the importance of considering the heart as a potential site for metastasis in patients with advanced cancer. The heart’s rich blood supply and lymphatic drainage make it susceptible to invasion by circulating cancer cells.

Recognizing Heart Cancer Symptoms & Causes

The symptoms of heart cancer are often non-specific and can mimic those of more common heart conditions, making early diagnosis challenging. Symptoms depend on the tumor’s size, location, and how it affects heart function or blood flow. Common indicators may include:

• Shortness of breath (dyspnea): Especially with exertion, due to fluid accumulation or obstruction of blood flow.
• Chest pain or discomfort: Which can be persistent or intermittent.
• Fatigue and weakness: General malaise often associated with advanced cancer.
• Arrhythmias: Irregular heartbeats, palpitations, or fainting spells if the tumor affects the heart’s electrical system.
• Fluid retention (edema): Swelling in the legs, ankles, or abdomen, indicative of heart failure.
• Unexplained weight loss: A common systemic symptom of many cancers.
• Embolic events: Pieces of the tumor breaking off and traveling to other parts of the body, causing strokes or blockages in other organs.

Regarding the causes of heart cancer, for primary cardiac tumors, the exact etiology is largely unknown. Some rare cases are associated with genetic syndromes, such as tuberous sclerosis complex, which can predispose individuals to benign cardiac rhabdomyomas that can occasionally become malignant. However, for most primary heart cancers, there are no clear risk factors. In contrast, secondary heart cancers are directly caused by the spread of cancer from a primary tumor located elsewhere in the body. The mechanism involves cancer cells detaching from the primary site, entering the bloodstream or lymphatic system, and traveling to the heart where they establish new growths.

Heart Cancer Treatment Options

The approach to heart cancer treatment options is highly individualized, depending on whether the tumor is primary or secondary, its type, size, location, stage, and the patient’s overall health. For primary malignant heart tumors, the primary goal is often surgical resection if the tumor is localized and can be safely removed without compromising vital heart structures. Complete surgical removal offers the best chance for long-term survival in resectable cases.

When surgery is not feasible or sufficient, other treatments may be employed. Chemotherapy is a systemic treatment that uses drugs to kill cancer cells and is often used for sarcomas and lymphomas of the heart. Radiation therapy, which uses high-energy rays to destroy cancer cells, may be used alone or in combination with surgery and chemotherapy, particularly for tumors that are difficult to resect or to alleviate symptoms. For metastatic heart cancer, treatment typically focuses on managing the primary cancer from which it originated. Palliative care is also crucial, aiming to relieve symptoms and improve quality of life, which may include targeted therapies or local radiation to reduce tumor size and alleviate symptoms like breathlessness or pain.