You may have heard that the American Heart Association issued a warning recently saying that life-saving breast cancer therapies like chemotherapy and radiation may cause heart failure or other serious cardiac problems, sometimes years after treatment.
Links between cardiovascular disease and breast cancer are complex, and this is the AHA’s first comprehensive scientific statement on the matter. The AHA cautioned that patients shouldn’t avoid chemotherapy and radiation treatments when their oncologists recommend them, but that they should take measures to minimize cardiac risks by exercising regularly and sticking to a healthy diet.
While it’s true that chemotherapy, radiation and some of newer breast cancer treatment agents can weaken the heart and lead to heart disease in some cases, medical oncologists have been cautioning breast cancer patients about this possibility for some time now. A patient’s overall health—including cardiovascular conditions—are always taken into account when considering which treatment plan to pursue. For example, women with pre-existing cardiovascular disease might be advised by their oncologist to receive a different type or duration of chemotherapy or radiation treatments.
Regardless, the goal with any breast cancer treatment is survival, so if chemotherapy and radiation are the best agents to achieve that, then women who need to have them should. The key is minimizing cardiac health risks before, during, and after breast cancer treatments.
What To Do To Minimize Risk
Exercising daily has two major benefits for women with breast cancer. First, it reduces a woman’s risk of dying from the cancer and second, it keeps the heart functioning as strongly as possible. I advise my patients to do some type of cardiovascular exercise—like walking, swimming, biking, or hiking—for 30 minutes every day if possible.
High cholesterol and high blood pressure are both factors that can increase the risk of a heart attack. Women (and men) with breast cancer should talk with their physicians about how to reduce their cholesterol and blood pressure levels, if needed, through diet or medications.
There’s also a test called a MUGA scan that can measure how well your heart is pumping with every heartbeat. The noninvasive scan can evaluate and monitor changes in how well the heart is functioning throughout a patient’s treatment. Based on the MUGA scan findings, physicians may advise a patient to alter their treatment or to pursue a different type of treatment.
Finally, as the American Heart Association report notes, advances in the treatment of breast cancer offer hope. For example, a common chemotherapy treatment is doxorubicin, which used to be called adriamycin. Its toxicity to the heart has been long known, but studies now indicate that administering the drug slowly, rather than all at once, may reduce the risk of cardiac damage.
Other small studies also have shown that a drug called dexrazoxane may reduce the risk of heart damage in patients who are receiving high doses of doxorubicin for advanced breast cancer. Larger studies are being conducted to confirm these results.
It’s also long been cautioned that radiation may cause blockages in the arteries of the heart, but modern and more-targeted radiation techniques exist and are being developed to reduce the risk of heart artery blockages.
The bottom line is that you don’t have to choose between life-saving breast cancer therapies and cardiovascular health. Between the lifestyle measures you can take to maintain your cardiovascular health and the recommendations your care team will tailor-make based your medical history and type of cancer, your chances for living free of cancer and cardiovascular disease are better than ever.
If you’d like to discuss the most advanced surgical treatments of breast cancer, consult with Dr. Aaron Margulies. Committed to serving breast cancer patients through his solo practice in Breast Surgical Oncology and General Surgery, Dr. Margulies has offices at Tennova Turkey Creek Medical Center in West Knoxville, at Tennova North Knoxville Medical Center in Powell, and at Jefferson Memorial Hospital in Newport. His extensive research and expertise in the have distinguished him as a leader in the field. To learn more about Dr. Margulies’ compassionate surgical care approach visit www.aaronmd.com or call (865) 692-1610.
