Is there a cancer of the heart?
DEAR DR. ROACH: I have heard of almost every organ or part of the body being attacked by cancer, but I’ve never heard of cancer of the heart. Can that be the case?
ANSWER: Tumors of the heart are extremely rare, seen in less than one person in a thousand, and an even smaller subset of those tumors are cancer. The most common tumor of the heart is called a myxoma, and these occur in the left or right atrium. They are common enough that I have seen a few in my career.
They can grow to a large size, and they cause problems by interfering with blood flow, and by predisposing a person to embolization — when small bits of tumor or clot break off, they can go to the lung, or in the case of left-sided tumors (or a septal defect, “hole in the heart”), to the brain.
About 15 per cent of cardiac tumors are cancers. The most common is a sarcoma, a cancer of connective tissue, such as muscle or the lining of the blood vessels. I fortunately have never had a patient with one of these.
DEAR DR. ROACH: My cancer doctor told me that progesterone should always be prescribed with estrogen. I was prescribed only progesterone by my family doctor. My doctor said this probably caused my uterine cancer.
My symptom of bleeding led to the early detection of my uterine cancer. Luckily, a hysterectomy removed all of my cancer.
ANSWER: Estrogen, taken without any kind of progesterone (we say “unopposed estrogen” for this situation) is a very strong risk factor for development of uterine cancer (it increases the risk more than sixfold), and almost never is done.
However, progesterone-type compounds alone (without estrogen) are commonly used, both for birth control and other indications, and actually protect against the development of endometrial cancer (they have been shown to reduce the risk by 80 per cent, but clearly not by 100 per cent). It sounds like the message got confused.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email to ToYourGoodHealth @med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.