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The cardio-cancer connection

Cancer survivors often unaware of cancer treatment-related heart disease


Since 1975, the five-year survival rate for cancer patients has increased from 50 percent to 68 percent, according to the American Cancer Society.

However, as treatments advance and life expectancies improve, another complication has emerged: increased cardiovascular disease among cancer survivors, according to the American Society of Clinical Oncology.

Studies also show that, after cancer recurrence, cardiovascular disease is the second leading cause of death for certain cancer types, according to Dr. William Ntim of the Novant Health Heart & Vascular Institute.

The stats

For cancers treated with radiation, Ntim said it’s estimated that radiation-induced cardiac disease occurs 10 to 30 percent of the time within five to 10 years after treatment. Patients who are treated with chemotherapy can also be affected. Studios show cardiovascular toxicity, or heart muscle damage from chemotherapy drugs called anthracyclines, occurs 30 percent of the time 37 months after treatment, Ntim said.

“These compelling statistics have prompted the National Cancer Institute to propose creation of a new field called cardio-oncology to research and manage cardiovascular disease among cancer patients,” he said.

The challenges

According to Ntim, cardiovascular toxicity with chemotherapy can appear almost immediately in some patients, while others may take months or years to show symptoms. Symptoms include heart failure, abnormal heart rhythm, heart attack or inflammation of the heart muscle or the area surrounding it. Sometimes heart function may start to decline without obvious symptoms, he said.

In radiation-induced cardiac disease, up to 88 percent of patients may have some abnormalities of the cardiac muscle, valves, area around the heart, conduction system and vascular system without clear symptoms. Head and neck cancer survivors are at an increased risk for carotid artery disease after radiation therapy.

The cardio-oncology connection is relatively new, however, which presents unique challenges when it comes to establishing guidelines to screen and treat heart disease in cancer patients, Ntim said.

“There is a lack of information when it comes to recommendations for heart and vascular disease screening and treatments targeting cancer patients and survivors treated with chemotherapy,” Ntim said.

Risk assessment tools that are used with the general population may have limitations when applied to cancer survivors, particularly those who are younger.

“Cancer patients need to know their baseline cardiac risk factors, such as cholesterol, blood pressure and family medical history, and they need to talk to their physician to find out how this may impact their care decisions,” Ntim said. “More research is needed to help understand the basis of cardio-oncologic diseases, along with screening guidelines and effective treatments.”

The education

During an upcoming education seminar, Ntim will speak about the important role cardiac ultrasound, or echocardiography, plays in cancer treatment. Participants will have the opportunity to see a live demonstration and talk to Novant Health experts about this painless test that can improve cardiovascular health in cancer survivors.

The event will take place Thursday, Nov. 5, at St. John’s Baptist Church at 300 Hawthorne Lane in Charlotte, North Carolina. A light dinner will be served at 5:30 p.m., followed by the program at 6 p.m.

Call 704-384-4400 to register today for the free event or click here. Space is limited.





Published: 10/23/2015