Breast Cancer Therapy: All Clear for the Heart

Excerpt:

“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.”

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History of Exercise Helps Prevent Heart Disease After Breast Cancer

Excerpt:

“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 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 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 and the cardiovascular benefits of exercise across all types of cancer treatments.”

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Mammograms to Screen for Breast Cancer Could Also Give Clues to Heart Disease Risk

Excerpt:

“Mammograms performed to check the health of the breasts could also give clues to the health of the heart, researchers say.

“That’s because the amount of calcium in the arteries of the breast, which can be seen on a digital mammogram, seems to reflect the amount of calcium in the coronary arteries, which supply blood to the heart.

“Although women are commonly screened for breast cancer with mammography, there is no routine screening test for heart disease. Calcium in the coronary arteries is known to be an early sign of heart disease. Finding a link between calcium in the breast arteries and calcium in the coronary arteries is a reason to ‘pay attention,’ study coauthor Dr. Jagat Narula from the Icahn School of Medicine at Mount Sinai in New York City told Reuters Health by email.”

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Heart Health After Cancer: A Growing Concern

“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.”


Hold Your Breath to Protect Your Heart

“Women who have breast cancer on their left side present a particular challenge to radiation oncologists. Studies have shown that the risk of heart disease is higher in this group of women after radiation treatment because it can be difficult to ensure that a sufficient dose of radiation is delivered to the left breast while adequately shielding the heart from exposure. New research shows a woman who holds her breath during radiation pulses can greatly reduce radiation exposure to the heart.

” ‘Radiation therapy is commonly prescribed to patients with breast cancer following surgery as a component of first-line therapy,’ said first author Harriet Eldredge-Hindy, M.D., a Chief Resident and researcher in the Department of Radiation Oncology at Thomas Jefferson University ‘We wanted to determine how effective breath-hold could be in shielding the heart from extraneous radiation exposure during treatment of the left breast.’

“Recent studies have shown women with cancer in the left breast are at higher risk of heart disease, and that the risk increases proportionately with the dose of radiation the heart is exposed to during treatment. A number of techniques have been developed to reduce exposure to the heart including prone positioning (lying flat on the belly on a bed that only exposes the left breast), intensity-modulated radiation therapy (IMRT), and accelerated partial breast irradiation. The breath-hold technique allows doctors to monitor a patient’s breath for the position that shifts the heart out of the range of the radiation beam.”


Prostate Cancer Medications Linked with Increased Risk of Heart-Related Deaths in Men with Cardiovascular Problems

“A new study has found that certain prostate cancer medications are linked with an increased risk of dying from heart-related causes in men with congestive heart failure or prior heart attacks. Published in BJU International, the findings will help doctors and patients weigh the benefits and risks of the drugs.

“Androgen deprivation therapy (ADT), which reduces levels of male hormones in the body to prevent them from stimulating cancer cells, is a mainstay of treatment for prostate cancer. Despite its anticancer effects, ADT has been associated with heart problems, including increased risk of diabetes, coronary heart disease, heart attacks, and sudden cardiac death. To investigate this potential link thoroughly, Paul Nguyen, MD, of the Dana-Farber/Brigham and Women’s Cancer Center in Boston, along with David Ziehr of Harvard Medical School and their colleagues, analyzed information on 5,077 men with prostate cancer who were treated between 1997 and 2006. Thirty percent of these men received ADT, while the others did not.

“After a median follow-up of 4.8 years, no association was detected between ADT and heart-related deaths in men with no cardiac risk factors (1.08 percent at five years for ADT versus 1.27 percent at five years for no ADT) or in men with diabetes, hypertension, or high cholesterol (2.09 percent vs 1.97 percent). However, ADT was associated with a 3.3-times increased risk of heart-related deaths, in men with congestive heart failure or prior heart attacks. In this subgroup, heart-related deaths occurred in 7.01 percent of men receiving ADT versus 2.01 percent of men not receiving after five years. This suggests that administering the therapy to 20 men in this potentially vulnerable subgroup could result in one cardiac death.

” ‘While androgen deprivation therapy can be a lifesaving drug for men with prostate cancer and significantly increase the cure rates when used with radiation for aggressive disease, this study also raises the possibility that a small subgroup of men who have significant heart disease could experience increased cardiac death on ADT,’ said Dr. Nguyen. He noted that because the study was retrospective, it must be carefully weighed against larger controlled trials that have demonstrated the benefits of ADT. ‘I would still say that for men with significant heart problems, we should try to avoid ADT when it is not necessary—such as for men with low-risk disease or men receiving ADT only to shrink the prostate prior to radiation. However, for men with high-risk disease, in whom the prostate-cancer benefits of ADT likely outweigh any potential cardiac harms, ADT should be given even if they have heart problems, but the patient should be followed closely by a cardiologist to ensure that he is being carefully watched and optimized from a cardiac perspective.’ “


Lung Cancer Scans Can Also Warn of Heart Disease Risk

Computed tomography (CT) scans are used to screen for possible lung cancer, but they can also be used to assess patients’ risk of heart disease, recent evidence shows. Doctors can use images of a patient’s chest region to look for calcium deposits in the blood vessels that supply the heart. Heavier deposits are associated with greater heart disease risk. A study of over 1,500 people who had undergone lung cancer screening found that a simple visual inspection of their CT scan images for calcium deposits was as successful in identifying their relative heart disease risk as the current ‘gold standard’ heart disease risk analysis. These findings are particularly relevant because people at high risk of lung cancer (ie, older people with a history of heavy smoking) are also more likely to have heart disease.


Cancer Survivors' Lifestyles Put Them at Risk for Heart Disease

A new study suggests that cancer survivors are at greater risk for heart disease, highlighting the need for incorporating lifestyle changes into their continuing care. In a self-reported survey, the researchers found that 1,582 people who had survived cancer (breast, colorectal, gynecologic, or prostate) also had more risk factors for cardiovascular disease including smoking, high body mass index, physical inactivity, hypertension, and diabetes. Hispanic and black survivors had more of these risk factors than white survivors. In addition, nearly one-third of those surveyed said that their health care provider had not suggested reducing their risk of heart disease by, for example, exercising and losing weight.


Cancer Survivors' Lifestyles Put Them at Risk for Heart Disease

A new study suggests that cancer survivors are at greater risk for heart disease, highlighting the need for incorporating lifestyle changes into their continuing care. In a self-reported survey, the researchers found that 1,582 people who had survived cancer (breast, colorectal, gynecologic, or prostate) also had more risk factors for cardiovascular disease including smoking, high body mass index, physical inactivity, hypertension, and diabetes. Hispanic and black survivors had more of these risk factors than white survivors. In addition, nearly one-third of those surveyed said that their health care provider had not suggested reducing their risk of heart disease by, for example, exercising and losing weight.