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Some breast cancer treatments may impact heart function
02 February 2018, 09:07 | Darrell Baldwin
AHA Addresses Heart Effects of Breast Cancer Tx
Statement author and cardiologist Dr. Laxmi Mehta and colleagues wrote that cancer treatment can result in a wide range of heart damage, including left ventricular systolic dysfunction; overt heart failure; hypertension; arrhythmias; myocardial ischemia; valvular disease; thromboembolic disease; pulmonary hypertension; and pericarditis.
However, it should not deter or scare patients from undergoing the cancer treatment, instead, allow them to make informed decisions with their doctor on the best option available, Mehta added, in the statement published in the journal Circulation. She further said that during the treatment the patient should not only concentrate on their breast health but also normal health involving the heart.
Another puzzle is why screening mammography, meant to detect breast cancer when it is supposedly more treatable, doesn't seem to reduce the risk of premature death from all causes, rather than breast cancer only.
Sometimes, the impact on the heart is only temporary, and the heart can regain proper function once the breast cancer treatment completes, or when the patient also adds heart medicine into the mix.
"We are still recommending that patients do get their breast cancer treatment". Catching heart failure early on could indicate that the patient needs a slightly modified treatment, or some extra care so as not to worsen the condition.
Some studies suggest that administering common chemotherapy therapies in new ways may reduce heart disease risks. For some patients, however, heart damage may be permanent. More studies will need to be done to confirm whether the results of the smaller studies are seen in larger groups of patients.
Dr. Pina, associate chief of cardiology at Montefiore Einstein Hospital in the Bronx, said lifesaving therapies-including radiation, chemotherapy, and other treatments-can cause serious heart problems, some of which might not materialize until years later. Yet when such a patient ends up in the hospital, he said, doctors tend to look for signs of a heart attack or pulmonary embolism, while overlooking breast cancer treatment as a possible culprit.
"It is less a problem today than 20 years ago, because we started aiming the beam to miss the heart about 20 years ago, but we occasionally see a woman who had lumpectomy and radiation, and the radiation beam caught part of the heart and a coronary artery", Brawley said.
There's a new warning about the connection between breast cancer and the leading killer of women: heart disease.
That's the key message in the American Heart Association's first scientific statement to address the topic. Life's Simple 7 includes being physically active, achieving and maintaining a healthy body weight, eating a healthy diet, avoiding tobacco, maintaining healthy levels of blood pressure, cholesterol and blood sugar.
The likelihood of cancer survivors dying from CVD vs cancer recurrence is increasing due to the improved efficacy of breast cancer therapies, making effective management and prevention of CVD a priority for this patient population as they age. "However, during and after the treatment of breast cancer, having optimal control of heart disease risk factors is important, because older breast cancer survivors are more likely to die of heart disease than breast cancer".
For breast cancer the mortality rate has come down by 10%, meaning deaths in women are declining more quickly.
And, of course, lifestyle changes can help prevent both diseases.
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