Cancer Patients Undergoing Treatment Incur a Risk of Cardiotoxicity and Lack Awareness

Many patients with cancer undergoing treatment incur a risk of cardiotoxicity, and these patients are not being made aware by physicians who may be unaware of the dangers themselves, according to a new study presented at the EuroHeartCare 2019, a scientific congress of the European Society of Cardiology (ESC).

“Depending on the type of chemotherapy and radiotherapy, between 1% and 25% patients [with cancer] may develop heart failure due to cancer treatment,” study author Robyn Clark, a professor at Flinders University in Adelaide, Australia, said in a press release. “Risk also depends on cardiovascular risk factors such as smoking and obesity. Better monitoring of the heart and intervention before, during, and after treatment can prevent or lessen the impact of this cardiotoxicity.”

As of 2012, more than 32 million people were living with cancer worldwide. As the number of cancer survivors rises and the number of patients >65 years old who require chronic cancer therapy grows, there is a need for more cardio-oncology services. These services are especially vital given that heart failure caused by cancer therapy can occur up to 20 years following treatment.

In this study, researchers evaluated the medical records of 46 arbitrarily selected patients with cancer with cardiotoxicity who received treatment at one of three hospitals between 1979 and 2015. Of the total population, almost 40% were categorized as either overweight or obese, 41% were current or former smokers, 24% were regular alcohol users, 48% had hypertension, and 26% had diabetes. Moreover, only 11% were referred to a cardiologist prior to chemotherapy and 48% were referred to a heart failure clinic following cancer treatment.

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Communication of Cardiology Needs Lacking

Results of the study suggest that out of 11 patients who were interviewed, of which seven had their records analyzed, no patient could communicate their cardiology health needs, while more than half lacked an understanding on how to maintain a balanced, healthy diet. These results are concerning considering recommendations published by the ESC in 2016 and 2018 state that patients with cancer should be informed about any potential heart risks prior to starting therapy. Furthermore, according to the recommendations, these patients should also be provided with assistance in quitting smoking, eating healthy, and controlling their weight. Patients should also be prompted to report any signs and symptoms of cardiovascular disease.

“Monitoring the heart throughout the cancer journey can ensure it is protected,” said Prof. Clark. “For patients [with cancer] who do develop heart failure, there are clinics that will improve their quality of life, but our study shows many are not referred.”

Prof. Clark added that “telephone calls to support and monitor those with cancer and heart failure would reduce the burden of hospital appoints, which patients said was a priority.”

“I’m here for breast cancer. Why are you talking to me about my heart?” https://t.co/aIX3OEBMy1

— Joel "Heart Prevention" Kahn MD, FACC (@drjkahn) May 4, 2019

'I'm here for breast cancer. Why are you talking to me about my heart?' | EurekAlert! Science News https://t.co/JU91CuUCnK

— Dr. Stuart Fischer (@TheFitDr) May 5, 2019