Cardiac Tumors: Preventing Heart Damage | CTCA
This is a common conundrum that cancer doctors face: Many of the treatments they use to fight cancer can do their jobs well, but at the same time, they can cause serious damage to the heart. Radiation therapy, for example, has been linked to an increased risk of heart attacks, heart failure, and arrhythmias, and some chemotherapy drugs carry a risk of high blood pressure and blood clots. The damage to the heart is usually severe, but its effects may not appear for years after cancer treatment ends. In an effort to mitigate the risk, oncologists are increasingly working with cardiologists and primary care physicians to prevent and manage heart complications that can result from cancer treatments. This burgeoning association has become so influential that it has become a major medical specialty called cardiac oncology.
“Our goal is to treat cancer in patients while protecting them from dangerous side effects. We never want to cause life-threatening cardiovascular disease in the future.” – Anthony Berry, MD – Chief of Ambulance Medicine at Cancer Centers America
What is cardiac oncology?
The treatment of cardiac tumors includes three main areas of focus: identifying cancer patients at high risk, preventing heart damage, and monitoring the patient’s progress. Before starting cancer treatment, oncologists consult the cancer patient’s primary care physician and/or cardiologist to identify chronic conditions, such as high blood pressure and diabetes, that increase the patient’s risk of cardiovascular problems. The information is then used to guide the patient’s treatment plan and to determine which treatments are prescribed, says Dr. Perry. Doctors also work together to recommend prevention-based lifestyle changes, such as diet or exercise regimens designed for weight loss or smoking cessation programs to help patients quit smoking, to help reduce heart disease risk. Once cancer treatment has begun, the cardiac oncology team monitors how certain treatments may affect the patient’s heart, making necessary adjustments.
In the past, doctors used an echocardiogram to measure changes in the heart’s ability to pump blood, as low rates could be a sign of treatment-related heart damage. However, doctors today can use a technique called stress imaging to determine if a treatment is likely to cause complications before signs of heart damage appear. These technological advances are helping expand options to reduce patients’ risk of heart problems, although the challenge remains daunting, says Dr. Perry. “Unfortunately, we’re seeing more heart disease risk from cancer treatments than ever before,” he says. “But we can’t stop the treatments because they work so well to fight cancer.”
One reason behind the increased heart risk: The recent wave of targeted drug approvals by the U.S. Food and Drug Administration “These drugs help us boost the fight against cancer,” says Dr. Berry. But many of them such as trastuzumab (Herceptin® ), which is commonly used to treat breast cancer, can affect the heart by reducing its ability to pump, which can lead to congestive heart failure. “Another factor is the increasing number of people diagnosed with cancer beyond treatment. The number of cancer survivors living in the United States has reached nearly 15.5 million, and this record is expected to reach 19 million by 2024. Although they Surviving cancer, these patients may have cardiovascular problems in the future due to the damage caused by cancer treatments.
As a cancer survivor, Dr. Berry knows that the risks of developing cardiovascular disease are higher than those of the average person. To treat Hodgkin’s lymphoma, Dr. Perry was given a combination of radiotherapy and doxorubicin (Adriamycin ® ), a drug that damages the cancer’s DNA but also has the potential to develop heart disease later in life. “I know I’m more likely to get heart disease,” he says. “This is why I must make sure to take the necessary precautions and undergo appropriate follow-up. Prevention and monitoring are important components of cardiac tumours.”