A healthy living blog from Marshfield Clinic Health System

Cancer treatments and the heart: What you should know

Senior man and woman eating breakfast together smiling - Cardiotoxicity

While some patients experience cardiotoxic effects, others could be on the same drug and have no such effects.

Some cancer patients face difficult circumstances because of an effect certain cancer drugs have on the heart, called cardiotoxicity. Cardiotoxicity occurs when there is damage to the heart muscle or an issue with the electrical function of the heart. It could occur during or after treatment.

Consequences of cardiotoxicity can be severe enough that a patient may not be able to receive certain cancer treatments.

“Cardiotoxicity is something that can be quite challenging, especially when the cancer drug has the potential to cure the cancer or prolong the person’s life,” said Dr. Isaac Yeboah, a Marshfield Clinic oncologist/hematologist. “Cardiotoxicity could manifest structurally – negatively impacting the function of the heart – or it could be an electrophysiological problem where the patient experiences an arrhythmia.”

Listen to your heart

Dr. Yeboah said the condition of a patient’s heart prior to initiating treatment will have a significant impact on how well the patient tolerates potentially cardiotoxic cancer drugs.

“If you have someone who walks into a treatment that could potentially damage the heart, and that person already has a history of heart attacks, diabetes or heart disease, that is a setup for experiencing cardiotoxicity pretty quickly,” Dr. Yeboah said.

Dr. Yeboah said he will often send a patient with a heart concern to their cardiologist to evaluate the condition of their heart or optimize their heart function before beginning cancer treatment.

“As patients go through the course of the cancer treatment, we are constantly evaluating their symptoms, how they’re feeling and how their heart is doing,” Dr. Yeboah said.

He said there are situations where certain cancer treatments have to be ruled out because a patient’s heart will not be able to tolerate those cancer drugs. In that situation, Dr. Yeboah said an honest conversation with the patient is needed to discuss potential risks and benefits of alternative treatments, which may have less cardiotoxicity, but may also not be as effective as the cardiotoxic drug.

Most patients won’t experience cardiotoxicity

While some patients experience cardiotoxic effects, others could be on the same drug and have no such effects.

“In fact, a majority of patients go through treatment without having any issues related to cardiotoxicity,” Dr. Yeboah said.

Anthracyclines are one group of cancer drugs used in chemotherapy that can have cardiotoxic effects. Dr. Yeboah said only a minority of cancer drugs have potential for cardiotoxicity, however, one cardiotoxic cancer drug may be effective in treatment of multiple cancers.

If you are concerned about cardiotoxicity and your cancer treatment, talk with your care team.

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