While cancer treatments, such as chemotherapy and radiation, are critical to cancer survival, research shows that some of these treatments may increase the risk of developing cardiovascular disease. Although these cardiovascular risks should not deter life-saving cancer treatment, knowledge of the risks may help patients and their physicians select the best treatment plan, allow the opportunity to prevent complications and increase awareness of the early signs of cancer-related cardiotoxicities.
Chemotherapy can cause cardiovascular disease via many different mechanisms. Some of the mechanisms in which chemotherapy can cause harm to the cardiovascular system include direct damage to heart cells, blocking growth of blood vessels, increasing blood pressure, activating the clotting system, inducing inflammation in the heart muscles or sac around the heart or interfering with the conduction system of the heart. Some heart conditions associated with chemotherapy treatments include congestive heart failure, coronary artery disease, hypertension, and arrhythmias such as slow heart rates or irregular heartbeats. Cancer survivors who may have a higher risk of these diseases include:
- Individuals with additional cardiac risk factors such as hypertension,
high cholesterol, diabetes, smoking history and older age
- Anyone who received treatment for Hodgkin’s lymphoma as a child
- Those who received higher doses of chemotherapy
- Those who were treated with doxorubicin (Adriamycin, daunorubicin)
- Those with cardiac disease prior to initiating cancer treatment
Radiation treatment can cause cardiovascular disease as well. Radiation can help cure cancer by damaging the cancer cells, but tissues or organs next to the cancer cells also can be damaged. For example, radiation to the neck can increase the risk of thyroid cancer or blockage in the carotid arteries. Patients with a history of breast cancer in the left breast are particularly at risk as the heart sits under the left breast. Radiation to the chest can lead to early narrowing of the heart arteries or heart attacks, damage to the heart valves, stiffening of the sac around the heart, arrhythmias or can directly damage the heart muscle.
It is not fully understood why some survivors develop heart problems after treatment and others do not. It is important for each survivor treated with chemotherapy or radiation to have regular medical check-ups and screenings so if a heart problem develops it can be detected and treated early.
There are a few steps that have shown to reduce the risk of heart disease during or after receiving cancer treatments. These include:
- Not smoking (or quitting if currently smoking)
- Maintaining a healthy body weight
- Healthy diet
- Moderate exercise for at least 30 minutes on most days of the week
Thanks to chemotherapy and radiation more and more people are surviving cancer. However, ongoing research is showing that many cancer survivors subsequently are developing cardiovascular disease. If you are having any type of cancer treatment, or have had cancer treatment in the past, its impact on your heart should be considered. A discussion about the cardiac risks of your cancer treatment can be discussed with your oncologist or a primary care physician/cardiologist with knowledge of the risks.
If you have received cancer treatment, talk to your doctor about seeing a cardiologist
if you are experiencing any of the following symptoms:
- irregular or slow heartbeats
- rapid heartbeats (tachycardia)
- shortness of breath
- dry cough
- edema (swelling) of the hands or feet
- chest pain
Knowing your unique risk factors can prevent or reduce the risk of developing heart disease or cancer-related cardiotoxicity. The MemorialCare Heart & Vascular Institute at Long Beach Memorial, offers private, personalized consultations for men and women with a cardiology nurse practitioner. The $55 heart screening includes a 12-lead electrocardiogram; cholesterol and blood sugar testing; blood pressure, weight and body mass index calculations; and a review of your eating habits and activity choices. To schedule a screening, call (562) 933-2460 or visit our section on Heart & Vascular Care.