Pericardial metastases

My husband was diagnosed with stage IV NSCLC adenocarcinoma in Oct '09.

He was feeling unwell for a week with nausea, coughing and chest tightness, I finally convinced him he needed to go to the hospital. He was diagnosed with a pericardial effusion (fluid around the heart), which needed to be urgently drained. Nearly three litres of fluid was drained from around his heart. The fluid was found to have cancer cells.
The doctor suspected my husband had a tumor on the pericardium (sac around the heart) which was the cause of the effusion.

After three weeks in hospital and numerous tests, scans, etc., a PET scan showed a tiny nodule (too small to biopsy) in his right upper lung, FDG accumulation to left and right hilar lymph nodes and the pericardium.

No obvious primary tumor was found but it is lung cancer. The oncologist thinks it has spread from the small nodule in the lung to the lymph nodes to the pericardium.

Chemo was organised and my husband had the first dose, then the pericardial effusion re-accumulated (8 weeks after the first one). This time they operated and created a pericardial window to keep draining the fluid permanently.
Chemo resumed when he had recovered somewhat from the operation. He had 4 cycles of chemo and handled it pretty well, the only side effects were tiredness and mouth ulcers.

CT scans since then have shown no progression so he is considered stable at the moment. No more chemo for now, the oncologist says we'll just "wait and see".

It is hard to comprehend he has stage IV cancer as he looks and feels so well. We can only hope he stays this way for as long as possible.

Does any one else have metastases to the pericardium?

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many, including myself, had it. Not fun, but nothing to lose sleep about. Oh, the punching/draining is suppose to be one-time deal if that is what you worry about

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Dear Husky,

Yes, I am familiar with this. My husband had the same fluid accumulation around the heart and lung, and on April 16th had a window made in the pericardium to drain fluids. They only took 500 cc's from the pericardium and about 1500 from the pleura. Which was considered alot. Your husband had a tremendous amount. The window keeps the fluid build up from recurring, which is great.

Then on May 21st, the surgeon inserted a pleurx catheter (that is the brand name here of the type of drain they used) that allows us to drain his pleura at home. I hate doing it, but is saves having to go into the hospital to be tapped, and does ease his breathing. I do it every other day, and he usually has about 6-700 cc's of fluid.

But, the sad news was the cancer is in the lining of the heart, and the fluids around the heart and lung. My husband's condition has changed dramatically since the surgery, and he is now in hospice care at home, and I fear he is not going to recover.

I have read there is a delicate operation that can remove the pericardium, but we are not at the same point you and your husband are. So that is not an option for us. I am not sure even if cancer patients are candidates for this anyway.

I will pray that your husband continues to do well. This is a devastating disease, and yet we never lose hope even at the darkest hours. Take good care, cherish each day and one another, and may God bless you both...
Always,
Peg

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My sister is in stage 4 non small cell lung cancer, and had the same problem earlier this year. Finally in April she had to have her pericardium removed completely. It was very high risk surgery, but she made it. She has not bounced back as she had before, but we are hopeful that there will be a positive outcome. Good luck

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quiz - has anyone ever heard of heart [cardiac] cancer? If not, do you ever wonder why?

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Thank you to everyone for your replies.
I have not been back as our internet was down and my husband has been sick.
He has been having a bit of pain in his upper abdomen with nausea, dizziness, weakness in legs and very pale. His oncologist prescribed indigestion/heartburn tablets when it first started but I don't think it is indigestion, I have never seen anyone get as sick as he is from indigestion. He also has diabetes type2 and his blood sugar levels have been high the past couple weeks.
Will be going to doctors again in the next few days as, to me, things just don't seem right. I'm worried cancer could be spreading.

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