Cardiac sarcomas are difficult to treat and often fatal. Even after treatment, chances of recurrence and spread to other organs are high
Cardiac sarcomas are difficult to treat and often fatal. Even after treatment, chances of recurrence and spread to other organs are high.
Surgery that involves the removal of the entire sarcoma from the heart remains the main treatment option that extends survival. There are reports of people surviving for years after complete surgical removal of the tumor. Radiotherapy and chemotherapy done after surgery have also helped improve outcomes in some people.
However, large-scale studies have reported that the average lifespan of people with cardiac sarcoma is 6 months without surgery. Some studies report that 90% of people with primary cardiac sarcoma treated only with medications survived for only 9-12 months.
According to a study that involved 44 people with primary right-sided cardiac sarcoma, people who received chemotherapy after the surgery lived for 20 months compared with those who did not receive chemotherapy who lived only for 9 months.
Survival rates of cardiac sarcoma:
- 1-year survival rate: 47%
- 3-year survival rate: 16%
- 5-year survival rate: 11%
What are complications of cardiac sarcoma?
Cardiac sarcoma can lead to potentially life-threatening complications:
- Heart attack: When small tumor pieces break and travel through the bloodstream, they can form a blood clot and block the artery that supplies the heart, leading to a heart attack. A heart attack can cause symptoms such as shortness of breath, sudden chest pain, nausea, vomiting, and excessive sweating.
- Stroke: When small tumor pieces break and travel through the bloodstream, they can form a blood clot and block the artery that supplies the brain, leading to a stroke. A stroke can cause weakness or complete paralysis in one or both sides of the body.
- Pulmonary embolism: When small tumor pieces break, they can get lodged in the artery that supplies the lungs and form a blood clot known as an embolus, causing pulmonary embolism. Pulmonary embolism causes sudden shortness of breath, chest pain, and cough (which may be bloody or blood-streaked).
- Pericarditis: Cardiac sarcoma can cause inflammation of the pericardium (the sac that surrounds the heart) and pericarditis. The main feature of pericarditis is a sharp and stabbing pain in the chest, often in the middle (behind the breastbone).
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How cardiac sarcomas are treated
Your doctor will assess various factors before determining the most appropriate course of treatment:
- Age
- Overall health
- Coexisting conditions
- Spread of the tumor
- Tolerance to medications or surgery
- Preference for certain treatment options
Surgery is the most effective treatment option for cardiac sarcoma. While it may not extend the survival of all people with the tumor, it is more helpful than medical therapy alone. Your doctor may recommend one of the following:
- Removing the tumor by open heart surgery: Small cardiac sarcomas can be removed through open heart surgery, in which the surgeon makes a large incision cut in the chest to open the rib cage and operates on the heart.
- Heart transplantation: If the tumor is very large, removal becomes difficult. In such cases, surgeons may recommend heart transplantation. You will have to take immunosuppressants for a long time to avoid your body rejecting the new heart.
- Removing the tumor by autotransplantation: This is a novel type of surgery in which your heart is removed for a period of time to remove the cardiac sarcoma completely, followed by placing your heart back in its original location.
- Chemotherapy and radiation therapy: Your doctor may recommend other cancer therapies such as chemotherapy or radiation therapy if the cardiac sarcoma has spread to other parts of your body. Chemotherapy involves administering drugs that destroy cancer cells, often given in the form of injections or oral pills. Radiation therapy involves the use of targeted high beams of waves that shrink the tumor.
- Clinical trial: You may have the option to participate in clinical trials that try newer medications for cardiac sarcoma. Ask your surgeon or cancer specialist for information.
Can you prevent cardiac sarcoma?
While cardiac sarcomas cannot be prevented, you can avoid risk factors for cancer:
- Smoking or using tobacco
- Excessive alcohol consumption
- Excessive sun exposure
- Excessive radiation exposure
If you have a family history of cardiac sarcoma, you can ask your doctor about genetic cancer screening. Early detection can improve the success of cancer treatment.
Medically Reviewed on 12/22/2021
References
Blackmon SH, Reardon MJ. Surgical treatment of primary cardiac sarcomas. Tex Heart Inst J. 2009;36(5):451-452.
Oliveira GH, Al-Kindi SG, Hoimes C, Park SJ. Characteristics and survival of malignant cardiac tumors: A 40-year analysis of >500 patients. Circulation. 2015 Dec 22;132(25):2395-2402.
Cardiac Sarcoma. https://emedicine.medscape.com/article/277297-overview#a1
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