A cancer diagnosis can be emotionally and physically overwhelming, especially for patients who already have compromised health. While battling cancer with chemotherapy and radiation, it's critical to understand the potential effects that cancer-fighting therapies can have on the heart.
"There is a higher likelihood of heart disease for cancer patients who already have two or more risk factors for cardiovascular disease, such as diabetes, high blood pressure, smoking, high cholesterol and obesity," says Dr. Payam Mehranpour, an interventional cardiologist affiliated with Sharp Grossmont Hospital.
Moreover, chemotherapy drugs and radiation directed to the chest have been shown to increase a person's risk for coronary artery disease, cardiomyopathy (weakening of heart muscles), abnormal heart rhythms and heart attack.
"Certain treatments are known to affect the cardiovascular system," says Dr. Reema Batra, an oncologist affiliated with Sharp Grossmont Hospital. "However, damage to the heart due to radiation or chemotherapy is based on how much is given."
Some drugs known to affect the cardiovascular system include:
- Anthracyclines (doxorubicin, daunorubicin)
- Mitoxantrone (Novantrone®)
- Paclitaxel (Taxol®)
- Trastuzumab (Herceptin®) and pertuzumab (Perjeta®)
"Although these drugs carry risk for heart damage, some of the effects may be reversible, meaning that they may go away after the drug is stopped, or can be managed with other medications," says Dr. Batra.
A recent study published in the Journal of Clinical Oncology, identified certain cancers that are linked to a higher risk for cardiovascular disease post-treatment. After analyzing data from more than 36,000 adult cancer survivors compared to those without cancer, researchers found that survivors diagnosed with breast, lung/bronchus, multiple myeloma and non-Hodgkin lymphoma had an increased risk for cardiovascular disease.
According to the study, increased risk may be due to the type of drugs used for treatment, lifestyle factors and other diseases the patient may already have had.
"This study demonstrates how important it is for clinicians to develop strategies to improve heart and vascular health in patients being treated for cancer who are at-risk for heart disease, both during and well after treatment has ended," says Dr. Mehranpour, who was not affiliated with the study.
For patients undergoing chemotherapy, ensuring cardiovascular health may include performing heart tests both before and during treatment, so that dosage adjustments can be made as needed.
Sometimes medications to protect the heart, such as dexrazoxane (Zinecard®), may be given before chemotherapy. There are also some anti-cancer drugs that can be delivered with a special fatty coating so that the drug only enters cancer cells and no other cells, therefore reducing potential side effects.
"A well-thought-out, multidisciplinary care plan; open discussion with patients; and diligent health monitoring are some steps that can be taken to decrease the risk or reverse cardiovascular disease in patients fighting cancer," says Dr. Batra. "As with all conditions and diseases, it is about caring for the whole body, the whole person, in order to improve one's outcome for survival and quality of life after cancer."
For the media: To talk with a Sharp doctor about the risks of heart disease for cancer patients, contact Erica Carlson, senior public relations specialist, at firstname.lastname@example.org.