Chemotherapy Can Increase the Risk of Future Heart Problems

Early detection is key in reducing the risk of heart failure in patients with cancer.

Cancer patients who have undergone chemotherapy face an increased risk for cardiac problems in the future, a recent study suggests.

Although chemotherapy has proven to be able to fight and kill cancer, it still has toxic properties that may cause complications for patients after treatment.

Anthracyclines are a chemotherapy most commonly used to treat cancers such as lymphoma, leukemia, and breast cancer. Unfortunately, these agents are also known to cause heart dysfunction.

"Cancer patients need to be aware of this possible side effect of certain chemotherapies,” said Barry Trachtenberg, MD, a cardiologist with the Houston Methodist DeBakey Heart & Vascular Center. “Obviously, it needs to be administered, but I think patients need to be closely monitored during and after treatment. It's really heartbreaking to tell patients who have fought and beat cancer that they now have to struggle with a heart that is failing."

Researchers evaluated 12,000 women who received chemotherapy in 2012. The results of the study showed that within 5 years, these women were 20% more likely to develop heart failure.

In the same study, researchers found that women over 75-years-old administered the combination of anthracycline and Herceptin were 40% more likely to develop heart failure.

"The damage to the heart can begin during treatment or not show up until years later,” Trachtenberg said. “The key is catching it early. Within the first 3 to 6 months there is a good chance to reverse the heart disease with standard medications such as ace inhibitors and beta blockers. After 6 months, it's very unlikely the heart function would return to normal."

If a patient’s left ventricle ejection fraction has dropped below normal levels, then the American Heart Association recommends that the chemotherapy treatment might need to be stopped completely.

Although a specific time period for monitoring is unclear, a standard echocardiogram is recommended for patients receiving anthracycline, as well as subsequent echocardiograms to try and prevent heart failure.

"Patients with risk factors for heart disease such as a family history, high blood pressure, diabetes, and those on chemotherapies known to have cardiac risks such as anthracyclines, should be tested regularly,” Trachtenberg said. “Those on high dose anthracyclines or on multiple agents that can damage the heart need even more careful monitoring. Fighting cancer is an incredibly tough battle for patients and the family and friends who go through it with them. We want to let people know about this possible side effect so they can take the proper steps to avoid another battle with heart disease."