Cardiac Health in Cancer Survivors: A Growing Need

As of 2025, there are over 18.6 million cancer survivors in the United States, representing about 1 in 18 Americans. By the year 2035, the number of cancer survivors is expected to surpass 22 million.

As a practicing thoracic medical oncologist, we often face difficult decisions with patients and family members. Are the side effects of treatment worth the benefits? Is cure achievable, and at what cost?

Dr. Dawn Mussallem is a true powerhouse and fountain of life. She holds dual board certifications in family medicine and lifestyle medicine, with a focus on cancer survivorship and integrative breast oncology. Prior to becoming the chief medical officer at Fountain Life, a health company focusing on transitioning health care from reactive to proactive by utilizing artificial intelligence-driven preventative care, Mussallem was in medical practice at the Robert and Monica Jacoby Center for Breast Health at the Mayo Clinic in Jacksonville, Florida.

Throughout her medical career she has helped thousands of people, but her personal story of perseverance and survival has inspired a movement. While most medical students in her class were studying for exams and learning about the inner working of the body, Mussallem was fighting for her life — diagnosed with an aggressive form of lymphoma and requiring grueling chemotherapy, radiation and bone marrow transplantation. Thankfully the treatment worked. Mussallem was cured … light at the end of a dark tunnel.

Weeks after delivering her first child, she began experiencing symptoms of shortness of breath and signs of heart failure. Now Mussallem was fighting another battle, likely caused by the adverse effects of the chemotherapy that cured her cancer. Heart failure due to most cancer treatments is uncommon; however, certain therapies may have higher risk than others.

Approximately 5% to 7% of people diagnosed with cancer will develop cardiac complications, including weakening of the heart muscle and arrythmia (abnormal heart rhythm), and cancer survivors have a 52% higher risk of heart failure compared to the matched general population.

“Wait a minute, we’ve got to be more mindful, in these young humans that we’re trying to cure, of the cancer, of the collateral damage along the way and what sort of things can help protect individuals in my situation who require these higher doses of chemo, require radiation more near the heart fields, and we’ve come so far because of individuals like me,” Mussallem says.

Mussallem is a testament to the courage and strength we see each day in clinical practice. Her story is a powerful message and warning to people newly diagnosed with cancer.

“Matters of the Heart” is an important reminder for us to be vigilant with our patients and our family members being treated for cancer. Monitoring for signs and symptoms of cardiac side effects are critical, allowing us to identify these changes and to act early and effectively.

Dr. Joshua K. Sabari
Assistant Professor
Department of Medicine
Thoracic Medical Oncology Developmental Therapeutics
Director, High Reliability Organization Initiatives
Perlmutter Cancer Center
NYU Langone Health

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