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Heart cancer :

  • Heart cancer results due to uncontrolled proliferation of heart cells or cells nearer to the heart.
  • Cancer that begins in the heart cells is called primary heart cancer.
  • The cancer that develops in the heart due to metastasis from distant site is called secondary heart cancer.
  • Heart cancer is mostly sarcoma that usually develops in the soft tissue of the body.
  • Primary malignant heart cancer is almost a rare entity.

Neoplasia :

  • Neo means new and plasia means growth.
  • Neoplasia refers to new growth.
  • It originates from a series of mutation that takes place in a cell or its clonal progeny cell.
  • It is a purposeless, progressive, parasitic growth.
  • Simply a tumor results due to neoplasia.

Divisions of Neoplasia :

  • Benign – Localized, Non – invasive and also non – metastatic.
  • Malignant – Invasive and also Metastatic

What sort of neoplasia is Heart cancer ?

  • If it primarily originates in the heart, then it is Malignant primary heart cancer.
  • And if it is due to distant metastasis with the primary tumor site at distant places of the body, then it is usually benign.
  • Cancerous tumor that begin in the heart are more often sarcomas, a type of cancer that originates in the soft tissues of the body.
  • The vast majority of heart tumors are benign ( non – cancerous ); they include myxomas, myomas, fibromas, rhabdomyomas hamartomas.
  • Although still rare, most cancers found in the heart are secondary, coming elsewhere from the body.
  • They include lymphomas that originates in the chest near the heart and spread by contiguity – direct.
  • Other cancers that spread to the heart includes melanomas and sarcomas – indirect spread.
  • Melanomas spread from the tumors arising from the black pigment forming cells.
  • Sarcomas are nothing but the tumors that have soft tissue origin.

Pathophysiology :

  • As already mentioned the primary malignant tumors of the heart is rare.
  • Though if it occurs , it is usually the Angiofibroma or Sarcoma with poor differentiation and MDM2 oncogene amplification.
  • Myxomas are the most common Primary tumor of the adult heart.
  • These are benign and arise from multipotent mesenchymal cells.
  • The sporadic myxomas do not show consistent genetic alterations.
  • But the familial syndromes associated with the myxomas have activating mutations in GNAS1 gene, encoding a subunit por null mutations in PRKAR1A gene.
  • About 90% of the myxomas arise in the atria with a left to right ratio of 4:1.
  • Rhabdomyosarcomas are the most common heart cancer in the pediatric age group.
  • This results due to the mutations in the tuberous serous complex TSC1 and TSC2 which are nothing but the tumor suppressor genes.

Clinical symptoms :

  • Fever
  • Malaise
  • Weight loss
  • Night sweats
  • Clubbing
  • And also Reynaud’s phenomenon

Does heart cancer occur in the heart truly ?

  • Yes cancer can occur in Heart but it is a rare entity.
  • Cancer/ Neoplasia is disease of the organs or tissues with actively dividing cells, wherein the cell proliferation/ division process goes out of the control. 
  • This may be due to viral infections or may be due to the changes in the DNA sequence. 
  • For example skin, intestine, bone marrow, have high populations of dividing cells and more often prone to cancer.
  • The heart cancer is called Angiosarcoma that does occur in the heart but very rare.
  • But on the whole it is more common in the children and also that too in the right side of the heart.
  • Cancer like melanoma are known to spread to the heart and most of the tumors are benign.

Reason for its rarity :

  • Heart cancer is extremely rare but the vast majority of Heart cancers are Noncancerous ( Benign )
  • The Heart muscle cells are essentially non-dividing and hence are not very susceptible to cancer.
  • Occasionally, cancer can spread to the heart from other parts of the body.

Treatment and its impact :

  • Treatment involves surgical removal of the tumor.
  • Cancer also affect the heart in different ways.
  • Those include damage to the heart valves or stiffening of the muscle.
  • Chemotherapy has also a greater impact on the heart tissue rather than controlling the tumor.
  • Radiation therapy directed at or near the heart can also damage the heart muscle and increase the risk of coronary artery disease later in life.

Life span of cells and Tumor :

  • The general belief is that the cells that divide regularly are more likely to develop tumor.
  • That is the tissues that are constantly regenerating that is the skin, intestines, etc., are more likely to develop cancer than the heart tissue whose cells never divide at all.
  • Nerve cells of the cerebral cortex, cells of the eye lens and most muscle cells last a life time.
  • Once dead they are never replaced.
  • But the cells of the skin are continuously lost.
  • They are replaced every two weeks or so.
  • The life span of the red blood cells are 120 days, platelets, 14 days and average lifespan of white blood cells is 2 weeks.
  • The cells lining the gut live only for 5 days but the average life of other Gut cells is around 15 years.
  • The liver cells are replaced every 300 to 500 days.
  • Cancer happens when the cells cease to obey the laws of cell division.
  • This starts during the cell division, when there is what is called the mutation.
  • So it remains natural that enhances the chances of development of mutants more in actively dividing cells and few in those that do not.
  • The new gene is a foreign antigen.

Immunology and tumor :

  • The chances of reacting to the foreign antigen develops late in the fetal life or even after birth.
  • That is the immunological response to a foreign antigen takes place in the late fetal life or after the birth.
  • All the potential antigens with which the cells are in contact is made after the period of immunological immaturity are recognized as self.
  • Moreover the material or antigen with which the first contact is made after the period are recognized as non-self .
  • This will evoke an immunological response.
  • A cell born out of a mutation is recognized as non-self and destroyed by the same immunological mechanism which rejects a transplanted kidney or heart

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