“Many breast cancer therapies cause damage to the heart. However, in the largest study of its kind so far, scientists from the German Cancer Research Center (DKFZ) in Heidelberg have now shown that the risk of death from heart disease in breast cancer patients following radiotherapy or chemotherapy is no higher than it is among the average population. Good risk management in the hospitals as well as control screenings at short intervals seem to make up for elevated risks.”
“While regular exercise is recommended as part of a heart-healthy lifestyle for any person, it also appears to help mitigate the increased cardiovascular risk faced by women treated for breast cancer, according to a study scheduled for presentation at the American College of Cardiology’s 66th Annual Scientific Session.
“The study found that women with breast cancer who engaged in the equivalent of five hours of moderate exercise per week before their diagnosis were 40 percent less likely to have a cardiovascular event and 60 percent less likely to die from coronary heart disease compared to those with a low pre-diagnosis level of exercise. Researchers said this study is the first to examine the long-term impact of exercise before a cancer diagnosis and the cardiovascular benefits of exercise across all types of cancer treatments.”
“Postmenopausal women with breast cancer who took aromatase inhibitors demonstrated endothelial dysfunction, a predictor of cardiovascular disease, according to study results presented at the 2016 San Antonio Breast Cancer Symposium, held Dec. 6–10.
“Aromatase inhibitors (AIs) are a class of drugs that lower estrogen levels, and have been shown to reduce breast cancer-related mortality in women with locally advanced curative intent estrogen receptor-positive disease, which accounts for 75 percent of breast cancer cases.
“However, estrogen also protects against heart disease, and recent research has suggested that the suppression of estrogen raises the risk of cardiovascular disease, said the study’s lead author, Anne H. Blaes, MD, MS, an associate professor in hematology and oncology at the University of Minnesota.”
“In a surprising study result, the use of intermittent androgen-deprivation therapy (ADT) for prostate cancer is not associated with fewer long-term adverse events than continuous ADT.
“The outcome was unexpected because it was hypothesized that the intermittent schedule, which gives patients a break from the treatment, would be less harmful.
“ADT is a cornerstone of locally advanced and metastatic prostate cancer treatment, but is associated with an array of adverse events, including sexual dysfunction, bone demineralization, cardiovascular disease, metabolic complications, cognitive changes, and diminished quality of life.”
“Breast cancer survivors with a family history of the disease, including those who carry BRCA1 and BRCA2 gene mutations, gained more weight over the course of four years than cancer-free women—especially if they were treated with chemotherapy, according to a prospective study by Johns Hopkins Kimmel Cancer Center researchers.
“Data from earlier studies suggest that breast cancer survivors who gain weight may have a higher risk of having their cancer return, the researchers say, noting that gains of 11 pounds or more are also associated with a higher risk of developing cardiovascular disease.
“For the study, the researchers reviewed a baseline questionnaire and a follow-up one completed four years later by 303 breast cancer survivors and 307 cancer-free women enrolled in an ongoing and long-term study at the Kimmel Cancer Center of women with a family history of breast or ovarian cancer. Study participants completed a baseline and at least one follow-up questionnaire between 2005 and 2013, and one-quarter of the subjects were premenopausal.”
“For men with prostate cancer (PCa), the risk for incident cardiovascular disease (CVD) is increased with androgen deprivation therapy (ADT), according to a study published online March 2 in the Journal of Clinical Oncology.
“Sean O’Farrell, from King’s College London, and colleagues used data on filled drug prescriptions in Swedish national health care registers to examine the risk of CVD associated with ADT in men with PCa. Data were collected in a cohort of 41,362 men with PCa on ADT and an age-matched PCa-free comparison cohort of 187,875 men. Overall, 10,656 men were on antiandrogens (AAs); 26,959 were on gonadotropin-releasing hormone (GnRH) agonists; and 3,747 underwent surgical orchiectomy from 2006 to 2012.
“Compared to the comparison cohort, the researchers found that the risk of CVD was increased in men on GnRH agonists (hazard ratio for incident CVD, 1.21) and in those who underwent orchiectomy (hazard ratio, 1.16). The risk of incident CVD was decreased for men on AAs (hazard ratio, 0.87). Men who experienced two or more cardiovascular events before therapy had the highest CVD risk during the first six months of ADT versus the comparison cohort, with hazard ratios of 1.91 for GnRH agonist therapy; 1.60 for AAs; and 1.79 for orchiectomy.”
“In a study reported in the Journal of Clinical Oncology, Krop et al found that ado-trastuzumab emtansine (Kadcyla) had an acceptable cardiac safety profile when used after anthracycline-based (neo)adjuvant therapy in women with early-stage HER2-positive breast cancer.
“In the study, 153 patients with a pretreatment left ventricular ejection fraction > 55% received (neo)adjuvant doxorubicin-cyclophosphamide for four cycles or fluorouracil, epirubicin, and cyclophosphamide for three or four cycles followed by ado-trastuzumab emtansine 3.6 mg/kg every 3 weeks for four cycles. Patients could then receive three or four cycles of docetaxel with or without trastuzumab (Herceptin). Ado-trastuzumab emtasine treatment was then resumed with optional sequential or concurrent radiotherapy for up to 1 year (17 cycles)…
“The investigators concluded: ‘Use of [ado-trastuzumab emtansine] for approximately 1 year after anthracycline-based chemotherapy was feasible and generally well tolerated by patients with HER2-positive [early-stage breast cancer], providing support for phase III trials of [ado-trastuzumab emtansine] in this setting.’ “
“Patients with prostate cancer who received androgen-deprivation therapy demonstrated an increased risk for cardiovascular disease, according to study results.
“Men with a previous history of cardiovascular events were at a particularly increased risk for cardiovascular disease (CVD) with androgen-deprivation therapy (ADT), results showed.
“Sean O’Farrell, BSc, MRes,of the division of cancer studies at King’s College London School of Medicine, and colleagues used the Swedish national health care registries to identify 41,362 patients who received ADT for prostate cancer. The analysis also included a control group of 187,785 age-matched, cancer-free men…
“ ‘Our study suggests an increased risk of CVD within the first year from starting GnRH agonist therapy or orchiectomy, especially in men with history of a CVD event within 1 year before ADT,’ O’Farrell and colleagues concluded. ‘There should be solid indication of use of ADT so that the perceived benefit outweighs possible harm. This is particularly important in men with a recent history of CVD.’ “
“Nearly 15 million people are living after a cancer diagnosis in the United States. This number represent over 4 percent of the population, an astonishing figure. And a growing one, as reported last year by the ACS and outlined by the NCI’s Office of Cancer Survivorship.
“As cancer patients survive longer they face additional health problems. Radiation to the chest, chemotherapy, antibody therapy and hormone changes can affect blood vessels and heart function in the short term and long, during treatment or years later. But millions affected – and their physicians – remain insufficiently mindful about the risk of heart disease.
“It’s the kind of problem a person who’s had cancer, or a doctor who’s prescribed generally helpful treatment, may not want to think about.
“Years ago, heart complications of cancer treatment didn’t garner so much attention says, Dr. Javid Moslehi, a cardiologist who leads a program in cardio-oncology at the Vanderbilt University School of Medicine in Nashville, TN. The emerging field involves cardiologists, oncologists, scientists and others who study the long-term effects of cancer treatment on the heart.”