Advances in cancer treatment have made it possible for patients to live longer. Despite their effectiveness, some cancer therapies can have bothersome side effects. The most common ones are fatigue, nausea and hair loss. Others, such as heart problems, are less common but more serious.
Not all cancer drugs have unintended effects on your heart. If the recommended treatment poses a risk to your heart health, your doctor may recommend a baseline heart test or a different drug or dose. Tell your oncologist if you already see a cardiologist for a heart condition and ask that they work together to care for your heart during your cancer treatment.
Understanding your treatment options and the risk they carry is essential. These five common questions and answers explore how to help prevent, manage, and in some cases, reverse heart damage due to cancer treatment.
Cardiotoxicity is the medical term for heart-related problems due to cancer treatment. It can appear during treatment or a year or more after finishing cancer treatment. Cardiotoxicity is rare but could happen in adults and those who received treatment for cancer as a child. It's also common in people who receive certain types of therapies, including chemotherapy agents such as anthracyclines, alkylating agents and antimetabolites; tyrosine kinase inhibitors and other targeted therapies; androgen deprivation therapy; immunotherapy; and radiation to the chest.
Certain cancer treatments can affect your heartbeat, blood vessels and heart valves. Treatment may also cause abnormal heart rhythms, blood clots, and cardiomyopathy. Some patients may also be more prone to developing high blood pressure or cholesterol, which contributes to heart disease. In more serious cases, it can lead to heart failure, stroke and heart attack.
Cancer patients with a history of heart disease may be more susceptible to heart problems. Age, genetics and your overall health can also play a role. People aged 60 or older, young children and women are at higher risk, as are those with a history of smoking or certain chronic conditions. If you see a cardiologist for a heart condition, it’s essential for both the cancer and heart care teams to work together.
Your cancer care team will suggest the best treatment options based on an evaluation of your health and your medical history. Depending on your test results or the tests you need, your doctor may refer you to a cardiologist. You may need to undergo a baseline heart function test if your doctor believes the recommended treatment may affect your heart. Your oncologist may also recommend a different drug or dose, or give the drug in a different way. Additionally, some medications can help protect your heart during treatment.
During and after cancer treatment, your doctor will listen to your heart and look for potential changes to your heartbeat. If something sounds or seems unusual, your doctor may perform more tests. Your care team may track your heart health during treatment depending on the drug you receive. If you develop heart problems after treatment, you will need medication to treat that condition, which may include therapy to help regulate your heartbeat or blood pressure.
Staying active throughout your cancer treatment is another way to help prevent heart problems. Research shows that exercise during treatment can help keep your heart and lungs healthy. Walking is ideal for most, but as always, it's best to check with your doctors before starting a new routine.
Before beginning any treatment for cancer, your cancer care team will review your medical and family history. Your doctor will then discuss the benefits and risks of your treatment options. Consider asking if the drug or drugs can affect your heart. Explore options with the cancer team for comparable treatments that are safer and less likely to result in heart side effects. Be sure to ask how effective other safer treatments are and whether you can join a clinical trial. If you have a heart condition such as cardiomyopathy, your doctor might suggest a different type of chemotherapy.
While cancer treatment helps patients live longer, it carries some risks. The good news is that many heart doctors collaborate with cancer care teams to help keep patients’ hearts healthy during and after cancer treatments. Understanding the connection between cancer treatment and heart health is essential. Discuss treatment concerns, benefits, side effects and ideal blood pressure range with your care team. And remember, physical activity is an important part of any cancer treatment plan.
Sources:
Investigating the Cardiac Side Effects of Cancer Treatments - NCI
Heart Problems Caused by Cancer Treatment | Cancer.Net
Protect Your Heart During Cancer Treatment
Cardiotoxicity | Division of Cancer Prevention
An Exercise Program for You: 5 Tips for People With Cancer | Cancer.Net
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