Cancer therapies damage the heart and blood vessels in a variety of ways. Conventional chemotherapeutic agents silently injure the heart muscle in as many as half of patients, diminishing the hearts pumping ability and increasing the risk of heart failure years later. Radiation therapy can cause scarring and tissue damage in the heart and lungs. Herceptin, a monoclonal antibody used in treating women with high-risk genetic profiles, is also associated with cardiac toxicity and heart failure. Experimental therapies that limit the growth of blood vessels in tumors can cause abnormal blood clotting, high blood pressure and reduced cardiac function. Even hormone therapy with aromatase inhibitors raises concern, given the long-term reduction in estrogen levels. Equally important, many women become physically inactive during cancer therapy, resulting in significant weight gain.
Keeping heart health in mind during breast cancer therapy can be as simple as performing a baseline evaluation of standard cardiovascular risk factors including age, blood pressure, cholesterol levels, smoking history and body weight. Depending on the results, the patient may need a prescription or a referral to a cardiologist.
Exercise is an important component of any treatment program. Even during cancer therapy, exercise will likely help a woman to feel better. In addition, Dr. Jones is doing research to determine whether exercise improves blood flow to the tumor, thereby enhancing delivery of cancer drugs to their intended target.
He is also studying whether exercise can protect the heart against the harmful effects of chemotherapy, for example, by improving blood pressure, reducing body weight and strengthening the hearts pumping ability. If exercise can improve tumor outcomes while protecting the cardiovascular system, that would be a very important finding, he said.
Dr. Jones believes that if oncologists e
|Contact: Amy Murphy|
American College of Cardiology