First, the good news: Thanks to earlier diagnoses and treatment advances, more people are surviving cancer. Today, there are more than 14 million cancer survivors in the United States. Unfortunately, it turns out that lifesaving cancer treatments can damage your heart and increase your risk of heart disease.
“Thirty years ago, being diagnosed with cancer was more frequently a fatal diagnosis, but now cancer can be cured in many cases and effectively treated in others. As a result, the number of people with a history of cancer is growing,” says UNC Health cardiologist Christopher Kelly, MD. “And those people are at increased risk of cardiovascular disease compared to the rest of the population.”
Dr. Kelly is part of a growing field called cardio-oncology that is made up of cardiologists and oncologists who are interested in managing the heart problems that can occur from cancer treatments.
Here’s what you need to know about the link between cancer treatment and heart disease and what you can do to minimize your risk.
1. Not everyone who undergoes cancer treatment is at risk of heart failure.
Rest assured, not all cancer treatments increase your risk of heart problems. But some do. These include certain drugs used for chemotherapy, radiation to the left side of the chest (such as for lymphoma or breast cancer) and newer immunotherapy treatments such as those that trigger the immune system to attack cancer cells.
For example, Herceptin, a drug used to treat 1 in 3 breast cancer patients, has a significant association with heart disease, Dr. Kelly says. “About 10 percent of the individuals who take Herceptin can develop heart disease as a result, so it is important to have regular screening. When heart problems do occur, close collaboration between the oncologist and cardiologist becomes essential,” he says.
2. Your risk of heart disease may affect the type of cancer treatment you receive.
That is why cancer patients who need Herceptin or other chemotherapies that can affect the heart are screened for heart disease before treatment, and patients who already have heart disease may not be good candidates to receive those treatments.
“If someone doesn’t have heart disease, we will continue to monitor them on a regular basis to make sure they don’t develop it,” Dr. Kelly says.
Although your oncologist may order tests to check for heart disease before, during and after your cancer treatment, Dr. Kelly says it is important to let your oncologist know if you have any heart problems. Your oncologist may refer you to a cardiologist to minimize the chances of those problems progressing and to make sure that the chemotherapy choices are safe.
3. You can develop heart problems long after treatment.
Even if you were not at risk of heart disease before treatment, you could develop it after treatment—but it might not happen immediately. Pay attention to changes or new symptoms you experience, even years after completing your cancer treatment.
Each type of heart disease has different symptoms, but many have similar warning signs. These include:
- Extreme fatigue
- Constant dizziness or lightheadedness
- A fast heart rate (more than 100 beats per minute)
- A new, irregular heartbeat
- Chest pain or discomfort during activity that goes away with rest
- Difficulty breathing during regular activities and at rest
Also, make sure your blood pressure is controlled, because high blood pressure is a precursor to more serious heart health conditions.
“Survivors of cancer rightfully feel like they’ve won their health back, and keeping your health means that you have to pay attention to the risk of heart disease,” Dr. Kelly says. “Make sure that you’re staying in touch with your doctor to monitor your heart health.”
Talk to your doctor about your risk of heart disease and cancer. Need a doctor? Find one near you.