There are many different kinds of side effects associated with cancer treatment, and issues with the heart is an uncommon, but serious one. The term “cardiac toxicity” refers to these side effects.
If you are receiving any treatment regimens that may cause cardiac toxicity you will be fully screened with cardiac tests before you are given any treatment, if there is no risk to you the treatment will commence. Your doctor will speak to you if there are any risks to you and will plan your treatment accordingly.
Only certain cancer treatments are linked with heart problems and there are ways to prevent or manage these side effects.
Symptoms of heart problems
If you feel that you may have developed heart issues, or have a pre-existing heart condition, these are the signs you should be looking out for-
- Shortness of breath
- Light-headedness or dizziness
- Discomfort or pain in the chest
- Fatigue
- Swollen hands and/or feet
- Extra heart beats that you can feel
If you recognise any of these symptoms in yourself, please contact your medical team immediately.
Causes of heart problems
- Chemotherapy with drugs called anthracyclines, including daunorubicin (Cerubidine), doxorubicin (Adriamycin, Doxil), epirubicin (Ellence), idarubicin (Idamycin), and valrubicin (Valstar) can cause heart issues in cancer patients.
- Radiation therapy to the chest is not easy on the body, and so can leave the heart susceptible to disease.
- Some types of targeted therapy, including bevacizumab (Avastin), trastuzumab (Herceptin), lapatinib (Tykerb), sunitinib (Sutent), and sorafenib (Nexavar) can also affect the hearts function.
Tests or heart disease:
- Physical exam: listening to your heart beat or the sound of blood moving through the major vessels in the neck can help your doctor determine whether or not you have heart disease. During this test, the doctor looks for usual sounds or changes to your heartbeat. These may be a sign that further tests are needed.
- Echocardiogram (echo). An ECHO uses sound waves and an electronic sensor to look at the heart’s structure and function.
- Multigated acquisition (MUGA) scan. A MUGA scan creates video imaging of the lower chambers of the heart that hold blood. These chambers are called “ventricles.” A MUGA scan checks whether the ventricles are pumping blood properly.
- Cardiac Magnetic Resonance Imaging (MRI). An MRI uses magnetic fields to takes images of the heart. Before the scan, the patient receives an injection of a special dye. The dye is called a contrast medium. And it creates a clearer picture.
- Blood tests. Certain signs of heart damage may show up in the blood. Your health care team can test for these.
- This procedure takes a picture of the blood vessels. First, you will have a dye injected into the artery. Then, the doctor examines the artery with a special x-ray device called a fluoroscope.
- Chest x-ray. A chest x-ray is a picture of the inside of the chest.
- Electrocardiogram (EKG, ECG). An EKG records the electrical activity of different areas of the heart as wavy lines on a piece of paper. This can show abnormal heart rhythms or heart damage.
Preventing and managing heart problems:
Your team will decide which is the best option for you, based on your fitness level, symptoms and family history. Some measures taken could be
- Changing your medication: Not all drugs cause heart problems. There may be equally effective drugs available that are not linked to heart problems.
- Changing your dosage or the way you take the drug: You may be able to receive a lower dose that still effectively treats the cancer but is less likely to affect the heart. Your doctor may also recommend a different method for giving the drug. Sometimes, a different method reduces heart damage.
- Reducing radiation therapy to the heart. This may include using a lower dose. Other techniques include:
- Intensity modulated radiation therapy (IMRT). This is a type of radiation therapy that directs the radiation dose at the tumour by varying the intensity of the beam.
For more information on how you can stay heart healthy, visit the Irish Heart Foundation.