Social media flooded with tributes to fashion designer Virgil Abloh after it was announced that the 41-year-old had died from a rare form of cancer.
"We are devastated to announce the passing of our beloved Virgil Abloh, a fiercely devoted father, husband, son, brother, and friend," reads the caption of a November 28 post on Abloh's Instagram account. "He is survived by his loving wife Shannon Abloh, his children Lowe Abloh and Grey Abloh, his sister Edwina Abloh, his parents Nee and Eunice Abloh, and numerous dear friends and colleagues."
Virgil Abloh Cardiac Angiosarcoma
What is cardiac angiosarcoma?
Cardiac angiosarcoma is a rare cancer that develops in the inner lining of blood vessels and lymph vessels, according to the National Cancer Institute (NCI). Angiosarcomas can happen anywhere in the body, but usually occur in the skin, breast, liver, and spleen. However, cardiac angiosarcoma happens in the chambers of the heart, Jack Jacoub, MD, medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, California, tells Health.
How common is cardiac angiosarcoma?
Angiosarcomas as a whole are diagnosed in about one in 1 million people in the US each year, per the NCI, making them incredibly rare. As just one type of angiosarcoma, that means cardiac angiosarcoma is even rarer.
"A very busy cancer doctor might see one or two [cases] in their whole career," Dr. Jacoub says.
And Ricardo Gonzalez, MD, chair of the Sarcoma Department at Moffitt Cancer Center in Tampa, Florida, tells Health that "most of these are spontaneous while a very small number may be associated with genetic syndromes."
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What are the symptoms of cardiac angiosarcoma?
Case reports on cardiac angiosarcoma point out that cardiac angiosarcoma can be difficult to diagnose, given that the initial symptoms are usually "non-specific." Dr. Jacoub agrees but says there are a few things that someone might notice with this form of cancer:
- Arrhythmia (where the heart beats too fast or too slow)
- Blood pooling in the legs and ankles, leading to swelling
- Chest pain
- Coughing up blood
The symptoms of cardiac angiosarcoma can often seem like other health conditions, and only a healthcare provider can tell if you have cancer, so it's important to see a doctor if you have any of these symptoms.
Who is at risk of developing cardiac angiosarcoma?
Given how rare cardiac angiosarcomas are, it's difficult for scientists to parse out exactly what the risk factors for this particular form of cancer are, Dr. Jacoub says. "There's not a certain lifestyle scenario that specifically raises your risk of cardiac angiosarcoma, like smoking and lung cancer," he says.
However, a gene called POT1 may cause cardic angiosarcoma to form, per the NCI, and it can be inherited through families.
Other factors are more typical with an increased cancer risk in general, Dr. Jacoub says, including having past radiation therapy or exposure to some cancer-causing chemicals.
How is cardiac angiosarcoma treated?
The condition is usually diagnosed when someone visits their doctor after having unusual symptoms, like fainting or dizziness, Dr. Jacoub says. Then, they'll have an ultrasound of their heart, followed by an MRI.
"At times, the tumor can look like a clot, which is vastly more common," Dr. Jacoub says, making this a difficult condition to diagnose. Once a patient is properly diagnosed, doctors will usually recommend surgery to try to remove the tumor. "That's really the best chance someone has," Dr. Jacoub says.
That will often be followed by chemotherapy to try to kill off any cancer cells that may remain.
Given how difficult it can be to operate on the chambers of the heart and because the cancer may have spread to other areas within the heart, Dr. Jacoub says that doctors may recommend a heart transplant in some cases. But, he points out, this isn't common. "Unfortunately, there really isn't a standard of care with cardiac angiosarcoma," Dr. Jacoub says.
The management steps will really depend on how far the cancer has spread, Teresa Lee, MD, PhD, an assistant professor at Fox Chase Cancer Center in Philadelphia, tells Health. "Because nonspecific symptoms can be common at first, cardiac angiosarcoma is often spread to other places in the body by the time it is discovered. In this case, treatments, including possibly chemotherapy or radiation, are aimed at relieving symptoms and hopefully prolonging survival by a few months."
What are the outcomes usually like with cardiac angiosarcoma?
If caught early, surgery—either removal of the tumor or an actual heart transplantation—may be curative, according to Dr. Lee.
But usually, cardiac angiosarcoma is a deadly disease. "Even with surgery, the prognosis is usually disappointing," Dr. Jacoub says. "The average survival after diagnosis is usually somewhere between six to 12 months."
"In the best of circumstances, patients may live a few years after surgery, chemotherapy, and radiation," Dr. Gonzalez says. "Most patients will live under one year. There are no absolutes in medicine; however I would consider with this largely a terminal diagnosis from the outside unless identified very early and the patient doesn't develop metastatic disease over the period of follow-up."
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