Anthracyclines May Increase Heart Failure in Patients with Breast Cancer, Lymphoma

Patients with breast cancer or lymphoma who were treated with a class of drugs called anthracyclines had a higher rate of congestive heart failure compared to those without a history of cancer, according to recent study results.

“The purpose of this study is since patients with cancer are surviving their cancer more and more with every decade that passes, there's still side effects of the medications, or also called chemotherapy, on different organs, specifically on the heart,” explained Dr. Hector R. Villarraga, author on the study and cardiologist at the Mayo Clinic in Rochester, Minnesota, in an interview with CURE®.

The study, which was published in the journal JAMA, included 812 patients with cancer and 1,384 participants without cancer.

Overall, patients with cancer had a higher risk of congestive heart failure compared to those without cancer, after adjusting for age, sex, diabetes, hypertension, coronary artery disease, hyperlipemia, obesity and smoking status.

Congestive heart failure was also greater for patients with cancer receiving anthracycline compared to participants who were not. This trend was observed at one year (1.81% patients with cancer versus 00.9% participants without cancer), five years (2.91% vs 0.79%), 10 years (5.36% vs 1.74%), 15 years (7.42% vs 3.18%) and 20 years (10.75% vs 4.98%).

“(These results) highlight the fact that big thing is patients with cancer have the same risk factors as patients with heart issues or cardiovascular patients,” Villarraga said.

This means that from day one of cancer treatment these patients need to be cognizant that they are at risk of heart problems as a side effect.

“This does not mean that we're not going to have cancer treatment, it just means we have to take care of better care of ourselves with the help of our primary care physician to see how we can protect our heart while we get the cancer treatment that is saving definitely a lot of lives, decade by decade,” he added.

A cancer diagnosis and treatment can be hard enough already, he explained, so to add taking care of heart health on top of that can be overwhelming. However, it is important because patients are living longer intro survivorship and this is where it can affect them.

He noted that the recent guidelines from the European Society of Cardiology suggest the use of an echo cardiography, which is an ultrasound of the heart, during treatment. The purpose is to detect initial cardiac issues so physicians can give the patient medication to avoid any further damage without discounting treatment for the cancer.

Another way for patients to maintain a healthy heart during cancer treatment is exercise and eating healthy. Exercising during treatment can be tough, but Villarraga suggests patients try to get 8,000 to 10,000 steps in a day, if possible, when they are feeling energized. And if patients are taking medications for hypertension, diabetes, cholesterol or blood pressure they should continue taking those and also ask a primary care physician what else they can do to keep a healthy heart.

“Even though you're diagnosed with cancer, survival is very good. And that's what's been demonstrated decade by decade since the 90s,” he concluded. “So keep your other organs healthy as well, especially your heart, because cancer survivors survive their cancer but can have issues with their heart that they lately in time can cause significant problems. So have a healthy lifestyle and always have very close contact with your primary care physician to see what else you have to do.”

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