When cancer and heart disease are combined, managing both conditions can be challenging for both patients and doctors. Because many cancer patients are over the age of 50, the chances are fairly high that they have pre-existing heart disease when diagnosed with cancer. Even those without Congestive Heart Failure (CHF) may develop heart problems as a result of the drugs they're taking for cancer treatment.
Chemotherapy drugs from the anthracycline family (including doxorubicin, epirubicin, idrarubicin and daunorubicin) are known to be "cardiotoxic," because they weaken the heart muscle. Chronic cardiotoxicity can occur in as little as a couple of weeks to as much as 10 years after treatment. Since many cardiotoxic drugs are used to treat childhood leukemias, heart health can become an issue for long-term cancer survivors.
Symptoms of Congestive Heart Failure (CHF)
Since the symptoms of CHF are very similar to cancer and other diseases like diabetes, obesity and cirrhosis, they often go unrecognized. The FACES system makes it easy to remember symptoms of CHF:
- Fatigue: have you been feeling more tired lately?
- Activity: has your activity level been altered?
- Congestion: are you feeling a tightness or congestion in the chest?
- Edema: do you have swelling in your ankles or lower extremities?
- Shortness of Breath: are you having trouble breathing?
People with any or all of these symptoms should undergo an echocardiogram to confirm congestive heart failure.
Treating Cancer-Related Heart Problems
Any pre-existing heart disease must be addressed before chemotherapy treatment can begin. A healthy heart is much more tolerant of aggressive cancer therapies than a diseased heart.
Chemotherapy-induced heart failure requires careful monitoring during and long after treatment. A blood test that measures the levels of Brain Natriuretic Peptide (BNP) can help detect heart failure, as well as assessing the effectiveness of treatment.
Two medications commonly used to treat high blood pressure, ACE inhibitors and beta-blockers, are extremely effective in treating weak heart muscle. For patients who do not respond to or cannot tolerate ACE inhibitors or beta-blockers, pacemakers may be an alternative.