Virgil Abloh, the celebrated fashion designer, died at 41 after being diagnosed with the rare cancer. Here\u2019s what we know about it.<\/b>
\nOn Sunday, Virgil Abloh, a noted designer and artistic director of men\u2019s fashion at Louis Vuitton, died at 41 in Chicago after a two-year battle with cardiac angiosarcoma. According to a statement released on his Instagram account, Mr. Abloh was diagnosed with the rare cancer in 2019 and underwent a number of treatments before he died. First described by doctors in 1934, cardiac angiosarcoma is a rare form of cancer that causes cells inside the blood vessels of the heart to multiply and form tumors. The cancerous cells are often found in blood vessels lining the musculature of the wall of the heart, said Dr. Robert Maki, a medical oncologist and the clinical director of the Sarcoma Program at Penn Medicine in Philadelphia. These cancers are part of a larger family of cancers called sarcomas, which affect the connective tissues that support and surround other parts of the body, including muscle, fat and blood vessels. Angiosarcomas are a kind of sarcoma that specifically afflict cells that line blood vessels, and cardiac angiosarcomas are angiosarcomas that occur within or around the heart. Cardiac angiosarcomas that begin in the heart are known as primary cardiac angiosarcomas, whereas cancers that form elsewhere and then spread to the heart are secondary cardiac angiosarcomas. It\u2019s unclear which kind Mr. Abloh had, but it\u2019s likely it was primary, said Dr. Sumeet Mitter, a cardiologist at The Mount Sinai Hospital in Manhattan, because if the tumor had originated elsewhere it would probably be described differently. Angiosarcomas are aggressive and can also spread, or metastasize, to other parts of the body, including the lungs, liver and bone marrow, Dr. Maki said. Cardiac angiosarcomas are extremely rare. Of the 17,000 or fewer people in the United States who are diagnosed with sarcomas each year, up to 700 are diagnosed with angiosarcomas, and then only 30 to 40 of those have cardiac angiosarcomas, Dr. Maki said. Angiosarcomas are more common in dogs, especially retrievers, Dr. Maki added, where they often afflict the spleen. Cardiac angiosarcomas can be difficult to identify because people often do not have symptoms, or they have only vague symptoms like shortness of breath or fatigue during physical exertion, said Dr. Ankit Mangla, a medical oncologist at the Case Comprehensive Cancer Center in Cleveland. These symptoms typically arise because the tumors make it harder for blood to flow through the chambers of the heart. But while many people experience shortness of breath and fatigue, only a very small portion of people with these symptoms have cardiac angiosarcoma. Typically, people have other heart problems instead \u2014 the heart muscle itself might be weak, or it may be too muscular and stiff, Dr. Maki said. Diagnosing these rare cancers can be difficult, because the tumors cannot always be seen using common imaging techniques such as CT scans, which are often administered to patients in emergency rooms who complain of shortness of breath, Dr. Mangla said. During a physical exam, a doctor might, however, be able to hear the sounds of blood rushing around the tumor. They might then conduct an ultrasound of the heart to visualize and identify a tumor, and then follow up with other kinds of imaging, including M.R.I., PET scan or three-dimensional echocardiography. It depends on the patient, but treatment might include surgery to try to remove the heart tumor, or a heart transplant. But sometimes \u2014 even in transplant patients \u2014 the tumor can reappear. Generally, if the cancer has not yet spread, it won\u2019t be treated with chemotherapy or radiation. \u201cIt\u2019s very rare for us to be able to treat just the heart itself with something like chemotherapy, and you also don\u2019t want to necessarily radiate the heart either, because that will damage it,\u201d Dr. Maki said. If the cancer has spread, though, a patient might undergo chemotherapy, radiation or treatment with other cancer-fighting drugs that can kill the spreading cancer. It is unclear whether Mr. Abloh\u2019s cancer had spread, but if he had it for two years, that is certainly possible, Dr. Maki said. Because cardiac angiosarcomas can damage the heart, which is a vital organ, and because they are aggressive and often spread, these cancers are often fatal. Some research suggests that if people do not undergo surgery, or their surgery does not remove all of the cancer, they typically survive for up to nine months, Dr. Mangla said. With surgery and other treatments, patients may live for 12 to 30 months. Because so few people are diagnosed with this kind of cancer, we don\u2019t know much about specific risk factors, Dr. Maki said. However, people are more likely to be diagnosed with angiosarcomas in general if they have undergone radiation therapy or have been exposed to high levels of vinyl chloride (a chemical used to make P.V.C.); arsenic; or thorium dioxide, a chemical people can be exposed to in drinking water if they live near sites that mine for the radioactive metal thorium or use it in manufacturing. Melinda Wenner Moyer is a contributing editor at Scientific American magazine and a regular contributor to The New York Times, The Washington Post and other publications. Her first book, \u201cHow to Raise Kids Who Aren\u2019t Assholes,\u201d was published in July.<\/p>\n