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Chemotherapy side effects: A cause of heart disease?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/chemotherapy-side-effects/AN01407
- With Mayo Clinic medical oncologist
Timothy J. Moynihan, M.D.
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Timothy J. Moynihan, M.D.
Timothy Moynihan, M.D.
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Dr. Moynihan, born in Las Vegas, N.M., and raised in Denver, is a consultant in medical oncology at Mayo Clinic and an associate professor at Mayo Clinic College of Medicine, Rochester, Minn. He's board certified in internal medicine, medical oncology, and hospice and palliative care medicine.
He did his medical oncology training at Johns Hopkins Hospital in Baltimore, and then went on to the University of Minnesota and St. Paul Regions Medical Center for seven years before moving to Mayo Clinic in 1999. Dr. Moynihan is medical director of the Mayo Clinic hospice.
Dr. Moynihan serves as the education chair for the Department of Oncology and the fellowship program director. Four times he has been selected as Teacher of the Year in medical oncology and elected to the Teacher of the Year Hall of Fame.
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Question
Chemotherapy side effects: A cause of heart disease?
Can chemotherapy side effects increase the risk of heart disease?
Answer
from Timothy J. Moynihan, M.D.
Chemotherapy side effects may include an increased risk of heart disease, especially weakening of the heart muscle (cardiomyopathy). Certain types of chemotherapy also increase the risk of heart attack, especially during infusion of the medication. Fortunately, heart disease associated with chemotherapy is relatively rare — and not all chemotherapy drugs carry the potential side effect of heart damage.
It's important to note that some newer anti-cancer treatments — such as trastuzumab (Herceptin) for breast cancer — may cause heart damage as well, although the effect is often temporary and reversible.
If your doctor is considering using a chemotherapy drug that may affect your heart, you may undergo heart function testing before starting treatment. During treatment, you may need periodic heart monitoring as well. If you have a pre-existing heart condition, such as cardiomyopathy, your doctor may suggest a different type of chemotherapy.
Generally, the risk of heart disease associated with certain chemotherapy drugs increases with the total lifetime amount of the drug you receive. To minimize the risk of heart damage, your doctor will carefully monitor the amount of each type of chemotherapy drug you receive. If you experience significant breathing problems such as shortness of breath with minimal exertion or chest pain during chemotherapy, report it immediately to your health care team.
In addition, some cancers require radiation therapy. If the area of your body receiving radiation includes your heart, you have an increased risk of cardiomyopathy, coronary artery disease and heart attack. The combination of radiation and chemotherapy can further increase your risk of heart damage. However, your doctor can take steps to reduce these risks as much as possible.
Next questionHigh-dose vitamin C: Can it kill cancer cells?
- Floyd J, et al. Cardiotoxicity of anthracycline-like chemotherapy agents. http://www.uptodate.com/home/index.html. Accessed July 26, 2010.
- Floyd J, et al. Cardiotoxicity of nonanthracycline cancer chemotherapy agents. http://www.uptodate.com/home/index.html. Accessed July 26, 2010.
- Perez EA, et al. Cardiotoxicity of trastuzumab. http://www.uptodate.com/home/index.html. Accessed July 26, 2010.
- Geiger S, et al. Anticancer therapy induced cardiotoxicity: Review of the literature. Anti-Cancer Drugs. 2010;21:578.
- Yusuf SW, et al. The diagnosis and management of cardiovascular disease in cancer patients. Current Problems in Cardiology. 2008;33:163.
- Sengupta PP, et al. Trastuzumab-induced cardiotoxicity: Heart failure at the crossroads. Mayo Clinic Proceedings. 2008;83:197.
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