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As cancer therapies become more successful, more patients survive and live long lives. While this is very positive, we must stay aware of the fact that patients can develop heart problems during and after cancer treatment. This effect is called cardiotoxicity.
This condition may present as high blood pressure, inflammation in the heart, heart valve problems, abnormal heart rhythms, damaged blood vessels, narrowed arteries, blood clots and, ultimately, heart failure.
Prominent symptoms of heart failure include shortness of breath, fatigue with normal physical activity, and swelling in your legs. Yet these can result from other causes, including cancer and treatment side effects. That’s why it’s important that your heart is monitored throughout cancer treatment, often through the use of echocardiograms and MRI.
Chemotherapy is very effective at destroying cancer cells. This also means it can damage healthy cells, including those in the heart. We know that certain cancer treatments can be toxic to the heart, including:
For example, breast cancer interventions include surgery, chemotherapy, radiation and hormonal therapy. One in five people will have “HER2-positive breast cancer” marked by high levels of a particular. For them, treatments such as trastuzumab (Herceptin) are used to target HER2. It is standard of care that clinicians assess these patients’ heart function every three months during treatment – because of the therapy’s cardiotoxic nature.
Oncology and cardiology teams should work together – as they do in our cardiotoxicity prevention program – to help prevent any heart problems during cancer treatment.
“Cardio-oncologists” are cardiologists who assess cancer patients before treatment, monitor their symptoms and heart function during treatment, and provide long-term follow-up after treatment.
A key goal is to minimize interruptions to cancer therapy, as delays influence long-term outcomes. Where necessary, your cardio-oncologist can start medications to stabilize and improve heart function while the oncology team continues to administer cancer therapy.
Patients should be empowered to self-monitor and self-manage their symptoms as part of cardiotoxicity prevention.
After the cancer therapy has finished, it’s important to stay to stay healthy and decrease any risk of heart damage. Tips include:
