Obesity. Smoking. High cholesterol. You’re probably thinking heart disease. But the same risk factors can lead to breast cancer. And to make things even trickier, some breast cancer treatments can impact how the heart functions and lead to cardiovascular disease.
For patients – even some cardiologists – there’s a lack of awareness about the critical combination.
Dr Tochi Okwuosa is an onco-cardiologist at Rush University Medical Center. As patients undergo cancer treatments – she monitors their heart health.
Dr Tochi Okwuosa: “The problem is, if you are at risk, and not everybody is at risk, you get through treatment, you get back to your regular life and all is well until all is not well, and somebody tells you, ‘You have heart failure.’”
Among the chemotherapies used in breast cancer that may compromise cardiac function, doxorubicin -- or Adriamycin -- and trastuzumab, also known as Herceptin. Both can weaken the heart muscle. And radiation can lead to valve damage and artery blockages.
Dr Okwuosa: “These drugs are very effective at what they do, so I don’t want anyone to take away the fact that, ‘Oh we shouldn’t take these drugs.’ hey are very effective. The problem is they can affect the heart if they are not monitored.”
That’s the key message in the American Heart Association’s first scientific statement to address the topic. In some cases, there may be alternative agents – or ways to adapt how the drugs are delivered so they don’t cause as much damage. But for all patients, the chemotherapies may be life-saving. That’s why monitoring is key.
Dr Okwuosa: “Making sure that they see the right person to determine if they need to start medication that would either prevent developing problems down the line from breast cancer treatment or actually treat a problem if they already have developed a heart problem as a result of treatment.”
The problems can occur in patients with healthy hearts going into treatment. But for patients who are obese, smoke and have high cholesterol or blood pressure – or those already diagnosed with heart disease -- the risk is even greater.
Dr Okwuosa: “If women with breast cancer are aware of these things ahead of time, they can be more proactive about their health.”
The monitoring needs to be ongoing – not just during treatment. That’s because the risk of developing a heart problem is lifelong with some of the treatments.