My work at the University of Michigan Frankel Cardiovascular Center focuses on preventing and minimizing heart damage that can be caused by cancer treatment. It’s a risk faced by more than 2 million breast cancer survivors who have had either chemotherapy or radiation.
I recently had the chance to talk to a group at Gilda’s Club of Metro Detroit, a community that provides emotional and social support for adults, teens and children living with any kind of cancer, and in October they turned their attention to breast cancer.
Here are some of the common questions I hear from breast cancer survivors:
What’s my risk? – Various cancer treatments can interact with the heart. Chemotherapy drugs, such as anthracyclines, designed to kill cancer cells can also harm heart muscle cells, causing a condition called cardiotoxicity. The risk can be low or high depending on the drug. Radiation therapy to the chest can lead to thickening or scarring of heart structures, such as the valves or pericardium (membrane surrounding the heart), and also affect the heart vessels, causing heart attacks. This could impact left-side breast cancer patients.
What kind of heart problems I can develop? Heart problems may develop during, or even years after cancer treatment. Cardiotoxicity can cause heart failure, high blood pressure, low blood pressure, heart attacks, irregular heartbeat, slow heart rate, or fluid around the heart. Radiation can cause heart valve disease, heart attacks, and thickening of the lining around the heart.
Is there anything I can do to prevent them? If you have cancer and want to avoid heart problems in the future, I recommend:
- low-cholesterol diet to avoid developing blockages in the heart vessels
- low-salt diet to avoid developing high blood pressure
- Get daily exercises, such as walking at least 15 to 30 minutes, as tolerated
- Avoid smoking and drinking alcoholic beverages
- Maintain healthy weight to avoid obesity and diabetes which increase your cardiac risks
What symptoms should I worry about? Symptoms caused by cardiotoxity can be common to the ones caused by cancer itself or treatment, such as fatigue, shortness of breath and leg swelling. In general, patients should tell their doctor if they have shortness of breath, chest pain, heart palpitations, fluid retention in the legs, distension of the stomach, dizziness or fainting. The Cardiologist should be able to examine you and run tests to determine if they are caused by heart problems or not.
Can I wait to treat my heart problems? Beating cancer is the first priority for women with breast cancer. Preventing and treating heart problems from cancer treatment can be coordinated with your Oncologist, so that you can conclude your cancer treatment. The goal of our Program is to ensure that breast cancer survivors have a healthy heart to enjoy the rest of their lives.
The Cardio-Oncology Program at the University of Michigan Frankel Cardiovascular Center treats patients with cardiac tumors and collaborates with cancer specialists to prevent and minimize heart damage caused by chemotherapy and radiation.