Can Cancer Cause Heart Disease?

People with cancer are well aware of the common side effects of cancer treatments. But they’re often surprised when they’re referred to a cardiologist for a side effect they didn’t know was possible with some cancer treatments: damage to the heart.

I work in what’s known as “cardio-oncology,” a field of medicine that has rapidly expanded over the past decade. Our goal in cardio-oncology is to help prevent and treat any cancer treatment-related complications of the heart and its blood vessels.

When I initially meet with a patient who has cancer, they naturally have a lot of questions. The first question is always, “Why would a treatment designed to attack my cancer also hurt my heart?”

It’s important for patients to know the answer to questions like these, whether they’re currently undergoing cancer treatment or if they’ve been treated for cancer in the past.

How cancer treatments can damage the heart

Chemotherapy and radiation therapy destroy cancer cells, but these powerful therapies can also damage healthy cells and tissues — including those in the heart.

As I explain to my patients, not all cancer treatments have the potential to harm the heart. Damage is more likely with certain types of chemotherapy drugs, and with radiation directed at the chest. For instance, in treating lung or breast cancer.

Some of my patients want to know if cardiotoxicity is common. In general, less than 10% of patients with cancer develop heart problems after receiving these therapies. But, if heart complications develop, the impact can be significant.

Some chemotherapy medicines can cause heart problems that include:

• Damage to the heart muscle that may lead to heart failure, meaning the heart no longer pumps blood as well as it should
• Disruptions to the heart’s electrical activity, which may cause abnormal heart rhythms
• High blood pressure, which can harm many organs throughout the body
• Myocarditis, which is a dangerous inflammation of the heart muscle

Radiation therapy to the chest region can increase the risk of:

• Coronary artery spasms — affect blood flow through the heart and cause angina (chest pain)
• Calcification (hardening) of the coronary arteries — this buildup of calcium and other substances in the arteries can block the heart’s blood supply
• Problems with the valves that allow blood to flow through the heart — the valves may stiffen or leak

Patients are more likely to have heart problems related to their cancer treatments if they have pre-existing heart disease or one or more risk factors, such as high blood pressure, diabetes or high cholesterol. Patients can also be at higher risk for heart problems if they’ve had chemotherapy or chest radiation in the past.

How we help protect our patients’ hearts

Patients with cancer may benefit from an evaluation by the specialists in our Cardio-Oncology Program if they:

1. Are going to receive a treatment known to cause heart damage and
2. Have risk factors like those I mentioned above

Most people are referred to our team by their oncologist before or during cancer treatment. We also evaluate and treat people who develop heart problems after their cancer treatments.

Our team's top priority is to help protect patients' hearts so that if they’re still in treatment, they can safely complete their vital cancer therapy. In the vast majority of cases, we’re able to do just that. And most people who do experience heart complications during or after their cancer treatments are able to fully recover their heart’s function.

What we offer to help prevent and treat cardiotoxicity

Because we have a dedicated Cardio-Oncology Program, we have an array of options available to help prevent cardiotoxicity and to treat it when it does occur.

Those options include:

• Helping patients manage conditions that put them at risk for heart problems (diabetes, high blood pressure or cholesterol levels, for example) so that their heart is less vulnerable to damage from cancer treatments.
• Prescribing medications that can help protect the heart from damage during cancer therapies.
• Prescribing medications that improve the heart’s function to patients who already have heart disease.
• Recommending dietary changes and other lifestyle changes, if necessary, to help keep a patient’s heart healthy during cancer treatment.
• Monitoring the cardiac function of patients when they start chemotherapy or radiation therapy using a variety of imaging tests to look for early signs of heart problems and treat them if they develop.

We work closely with oncologists to coordinate the safest, most effective therapies possible.

For instance, an oncologist may be able to prescribe a different chemotherapy drug for a patient that’s less toxic to the heart if that patient is already at risk for cardiotoxicity or has already developed it. Or, a patient with cardiotoxicity may be able to pause their cancer treatment for a bit — while we get their heart problem under control — before resuming their cancer therapy.

It may not always be possible to adjust cancer therapies in these ways and still achieve the same treatment results for cancer, which is why we coordinate care with oncologists. This is part of what makes our efforts to prevent or manage heart damage especially vital. It’s deeply gratifying to offer this life-changing care to a person who has, or had, cancer.

Get the treatment you need to protect your heart

At Temple, we place great care and emphasis on collaboration across departments. And in managing the health of your heart, that’s key.

If you or a loved one has been diagnosed with cancer, your oncologist may refer you to our Cardio-Oncology Program for an evaluation. You can also ask your oncologist for a referral.