Along with surgery, treatments such as radiation therapy, chemotherapy, targeted therapy, and hormonal therapy make breast cancer a treatable disease. Because these treatments have unavoidable effects on healthy, normal cells as well as cancer cells, there are pros and cons associated with each one. Some of the undesirable side effects may include damage to the heart. This is why these treatments are used with caution and care.
Some of the improvements in cancer care are because existing treatments are being used in new, better, and safer ways. For example, new radiation therapy techniques and computer technology now make it possible to dramatically minimize unintended exposure of healthy tissue -- such as the heart -- to radiation that is treating cancer. Even so, each treatment mentioned above can affect the heart in one way or another and increase the risk for heart disease later in life.
Maintaining a "heart healthy" lifestyle is important for everyone. But it's especially important if you're being treated for breast cancer. You can't change the fact that you needed treatment. But you can reduce your risk of cardiovascular disease by changing factors you can control:
These steps aren't just heart healthy; they also can help reduce your risk of the cancer coming back.
It's also very important that you regularly see a doctor who is familiar with your breast cancer treatment history and understands your special risks. Together, you can come up with a counseling, monitoring, and screening plan that takes into account any possible complications from earlier treatment.
NEW YORK (Reuters Health) - Authors of a report released this week encourage women who survive breast cancer to address all of the modifiable risk factors they have for heart disease, because breast cancer therapy can damage the heart.
Thanks to new and improved therapies, death rates from breast cancer have fallen dramatically in recent years -- by nearly one quarter between 1990 and 2000; yet these improvements may ultimately be diminished by the heart-damaging effects of these live-saving therapies, the researchers warn in the Journal of the American College of Cardiology.
Most breast cancer therapies, including new treatments still being developed, increase a woman's long-term risk of heart disease. "We don't know exactly how large the added risk is, but we believe it's substantial," first author Dr. Lee W. Jones of Duke University in Durham, North Carolina, commented in a written statement.
Chemotherapy may damage the heart in as many as half of patients, diminishing the heart's pumping ability and increasing the risk of heart failure years later. Radiation therapy can cause scarring and tissue damage to the heart and lungs.
Herceptin, often given to women with high-risk genetic profiles, is also toxic to the heart, while experimental therapies that interfere with the growth of blood vessels that feed tumors can cause abnormal blood clotting, high blood pressure and reduced heart function.
Hormone therapies, such as tamoxifen, which reduce estrogen levels for a long time, may also be hard on the heart.
Women and their doctors need to focus not only on the immediate threat posed by breast cancer, but also on long-term cardiovascular health, the authors say. "There are millions of American women living with breast cancer," Dr. Pamela S. Douglas, co-author and chief of cardiology at Duke, said in a written statement. "It's important that they don't squander their second lease on life."
More than 200,000 largely middle-aged and older American women are diagnosed with breast cancer each year. At the time of diagnosis, these women are often already at heightened risk for heart trouble, having age-related risk factors for heart disease, such as high blood pressure. They may also lead a physically inactive lifestyle and be obese, two factors linked to breast cancer and heart disease.
Equally important, many women curb their level of physical activity during breast cancer therapy and gain weight as a result. Maintaining an active lifestyle is an important in women with breast cancer, the authors emphasize.
Exercise is likely to help women feel better during breast cancer treatment, and Jones thinks it might also improve blood flow to the tumor, thereby enhancing delivery of cancer drugs to their intended target.
Jones is currently investigating whether exercise can protect the heart against the damaging effects of chemotherapy, for example, by lowering blood pressure, reducing body weight and strengthening the heart's pumping action.
"If exercise can improve tumor outcomes while protecting the cardiovascular system, that would be a very important finding," the researcher said.
SOURCE: Journal of the American College of Cardiology, October 9, 2007.
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