Decades of research and improved treatment – along with increased awareness of the importance of early detection – have enabled the majority of those diagnosed with cancer to live longer and fuller lives. According to the latest statistics from the American Cancer Society, the five-year survival rate for all cancers has risen to a record high of 67%, while the US cancer death rate fell 29% from 1991 to 2017.
This is good news in all respects, but as many survivors can testify, their battle with cancer often has lasting effects on their general health. Cancer therapies increase the risk of heart disease and increase the need for cardio-oncology, an emerging area of cardiovascular medicine that mitigates the effects of cancer treatment on the cardiovascular system.
Cardio-oncologists work with patients with heart disease or at risk for heart disease prior to starting cancer treatment, patients with heart disease during cancer treatment, and cancer survivors whose hearts have been damaged by chemotherapy drugs and radiation therapy.
Cardiovascular disease is the leading cause of death in women, and the incidence of cardiovascular disease increases with the onset of menopause (due to decreased levels of estrogen) and after treatment for breast cancer. This is important because breast cancer is the most common diagnosis for non-skin cancer in American women. One in eight women is likely to develop the disease at some point in their lives.
The double-edged sword of cancer treatment
Even if you’ve never had cardiovascular problems before your cancer diagnosis, you may need to see a cardio-oncologist because chemotherapy, radiation therapy, and certain targeted cancer therapies can potentially damage your heart.
Cardio-oncologists are studying the cardiovascular toxicity of certain treatments and are aware of their potential to increase the risk of heart disease. For example, chemotherapy has been linked to increased episodes of cardiomyopathy (weakening of the heart muscle), arrhythmias, heart attacks, strokes, high blood pressure, and blood clots.
A cardio-oncologist may offer regular imaging and screening, along with blood tests, during your cancer treatment to look for signs of heart problems and may change your treatment as needed.
If you are diagnosed with cancer and have heart disease or are at high risk for heart disease, a cardio-oncologist will incorporate your cancer treatment into your cardiovascular care. Your history of heart disease and risk factors for heart disease will be taken into account when your doctor chooses the chemotherapy drugs you will receive and the doses you will take.
Ask your cardio-oncologist to educate you about the possible effects of chemotherapy drugs and radiation on your heart and how problems are treated during and after your cancer therapy.
Reduce your risk
Make sure to consider your heart health during your routine wellness visits so that you can address existing issues – regardless of a cancer diagnosis. If you have high blood pressure or high cholesterol, both conditions can be treated with diet and lifestyle changes, and medication if necessary. In fact, some studies suggest that drugs used to control high blood pressure and high cholesterol can be protective during chemotherapy.
The risk factors for breast cancer and cardiovascular disease are remarkably similar. The two major risk factors that women have some control over are diet and exercise. Other major risk factors include age (especially after menopause), being overweight or obese, high blood pressure, high cholesterol, a family history of heart disease, and smoking.
To lower your overall risk for cancer and heart disease, work on changing your diet to include more fruits and vegetables, healthy proteins and whole grains, and less salt and saturated fats. Eating a heart-healthy diet like the DASH diet that is low in salt and saturated fats and avoiding processed foods, saturated fats, and refined sugars can help you lose weight. Other important steps include quitting smoking and following the American Heart Association guidelines for 150 minutes of physical activity per week.
Research shows that women who took part in exercise routines prior to being diagnosed with breast cancer are much less likely to experience cardiovascular problems years after cancer treatment. Because the risk of heart failure, myocardial ischemia (decreased blood flow to the heart), and high blood pressure is increased in cancer survivors, these steps are critical.
Working with your cardio-oncologist to care for your heart before, during, and after cancer treatment can help improve your heart health and quality of life. After surviving cancer, you deserve it.
This resource was created with the assistance of Merck.