According to the Centers for Disease Control, about 5 million people in the U.S. suffer from heart failure, which is a general term for a type of heart disease where the heart is weak and pumps less blood per beat than a healthy heart should, leading to fluid backup into your lungs and body. Of those 5 million, many will unfortunately be diagnosed with cancer, and many of those people will require chemotherapy. Understanding the effects that chemotherapy may have on your already weak heart is essential to making an informed decision about your cancer therapy. Here’s what you need to know before starting chemo treatment with existing heart disease.
Chemotherapy and heart health
There are multiple types of drugs used in chemotherapy, and while they are effective in treating your cancer, sometimes they can have side effects related to your heart. According to the Mayo Clinic, certain drugs, such as anthracyclines, can weaken the heart muscle. Many of these side effects are related to how high the dose of the chemotherapy is and how much you take over the course of your lifetime. Your oncologist will usually decrease the dose if you have heart disease to avoid complications, so it is vital to let your care team know about your condition. Armed with your heart health history, your care team can adjust your chemotherapy regimen to reduce the risk of further damage to your heart.
Frequent monitoring for early detection
The most important things you can do as a patient with heart disease undergoing chemotherapy is to monitor your condition carefully and contact your care team as soon as you notice any changes. Prior to chemotherapy, you should have an echocardiogram (an ultrasound of your heart) to determine your baseline heart function. While there are no required guidelines for how often to repeat the echocardiogram, talk with your oncologist and cardiologist about repeating it half way through your treatment to make sure your heart is not getting weaker. It is important that your cardiologist is part of your care team, so loop them in as early as you can.
Managing other risk factors
Heart disease and cancer are different in many ways, but they share several risk factors. Exercising daily, reaching and maintaining a healthy weight and quitting smoking can help reduce your risk of developing both conditions. If you were diagnosed with cancer and will be getting chemotherapy, it is very important that you try to maintain your heart health by controlling your blood pressure and cholesterol, too.
If, despite your best efforts, your heart function decreases from the chemotherapy, there are some treatment alternatives. Depending on your heart’s strength, you can discuss starting a class of blood pressure medications called beta blockers or ACE inhibitors with your doctor. According to GroupHealth Cooperative, these medications can protect your heart and allow you to live a longer, healthier life, and preclinical studies show a promising potential of better success rates for cancer patients taking beta blockers according to the National Institutes of Health.
If you are proactive in your treatments, control your risk factors and take your heart disease medications religiously, you can minimize the effects that chemotherapy may have on your heart, and maximize your quality of life after your treatment ends.
UVA offers echocardiography, a specialized heart attack recovery clinic and more at their heart and vascular center.