Heart cancer - also called cardiac sarcoma - may be a tumor that developed on the heart itself, or it may be a cancer that spread from another part of the body.
A cardiac tumor is an abnormal growth of tissue in the heart that may be either cancerous (malignant) or non-cancerous (benign).
“Primary cardiac tumors (ones that start in the heart) are very rare, with an incidence of around 0.001-0.3% of the population,” says Dr. Kelly M. Wanamaker, a cardiac surgeon at Baystate Medical Center. “The cells in the heart do not divide and multiply like the cells in other organs in the body, which makes cancer less likely to develop there.”
If a cancer is found in the heart, it most likely spread from elsewhere in the body, says Dr. Wanamaker. Cancers that may affect the heart include lung, breast, esophageal, kidney, leukemia and melanoma.
What is the Most Common Type of Heart Cancer?
The most common malignant cancer that originates in the heart, while quite rare, is angiosarcoma, an aggressive type of cancer made up of abnormal blood vessels. The good news is that 90% of cardiac tumors are benign (non-cancerous) and treatable.
“Myxoma is the most common primary benign tumor of the heart,” says Dr. Wanamaker. “These tumors are more commonly found in women, and 80% of tumors are found in the left atrium, the top chamber of the left side of the heart that receives blood from the lungs.”
Myxomas normally grow from the inter-atrial septum (the wall that separates the two atria, the top chambers of the heart). Their cause is not clear. Approximately 10% are genetic (passed down through families). These are called familial myxomas and are more likely to be numerous and occur in younger patients.
Heart Cancer Symptoms
It's impossible to tell without imaging whether symptoms are caused by a malignant heart cancer or a benign heart tumor. Since these symptoms may be very similar to those of other heart disease conditions, patients should discuss with their doctor to ensure they get the right treatment for what is causing their symptoms.
“Many patients who have a cardiac tumor have no symptoms at all – and for those patients who do have symptoms, they are typically similar to many other more common cardiovascular conditions,” says Dr. Wanamaker. “They are often found incidentally on imaging such as an ultrasound of the heart (echocardiogram) or CT scan for other reasons.”
Heart tumor symptoms are dependent on a tumor’s size, primary location, and growth and may include:
- Heart failure (shortness of breath, leg swelling, inability to lie flat)
- Arrhythmia (irregular heartbeat)
- Chest pain
- Stroke (slurred speech, weakness, vision loss)
- Pericardial effusion (fluid/blood/tumor within the sac that surrounds the heart)
- Fever, weight loss, and elevated inflammatory markers
How are Heart Cancer or Heart Tumors Diagnosed?
Cardiac tumors like myxomas are usually diagnosed by echocardiogram (cardiac ultrasound). Further non-invasive imaging with computed tomography (CT scan), magnetic resonance imaging (MRI), or positron emission tomography (PET scan) may help to better characterize and diagnose a heart tumor.
Heart Cancer Treatment
Heart cancer is often treatable. A multi-disciplinary care team that includes cardiologists, radiologists, oncologists, and cardiac surgeons collaborate to develop an individualized treatment plan for each patient. The care team will recommend treatment options based on factors including type of tumor, tumor size and location, whether or not the tumor has spread, and the patient's overall health status.
After removal of a malignant heart tumor, patients may need chemotherapy or radiation therapy to prevent recurrence of the tumor and relieve symptoms. Myxomas can only be treated by removing the tumor. This prevents complications including arrhythmias, heart failure, or an embolism, which can cause stroke or blockage of blood flow to other organs. Complete removal is important because “on occasion, this type of tumor can grow back,” says Dr. Wanamaker.
Despite that risk, the overall prognosis for those with myxomas is very good. Patients find with tumor removal, their symptoms and discomfort disappear, and they can enjoy life again.
“I’ve only had to perform a handful of these surgeries during my medical career,” says Dr. Wannamaker, “but every one of my patients did very well and were able to go back to leading healthy, normal lives.”