Cancer treatment is a complex process that requires a dedicated team of professionals working together. Oncologists, radiation oncologists, primary care providers and patients all have a hand in treatment. More recently, cardiologists have joined the table. The emerging field, called cardio oncology, considers how cancer treatment affects the heart.
Laura DeBenedetti, MD, FACC, a cardiologist with ProMedica Physicians, explained that all cancer treatments affect the whole body.
“Always with the treatment of cancer there are risks and benefits. Treatments increase free radicals, which cause inflammation, and with certain types of chemotherapy, we see certain risks to the heart,” she explained. “The concept of ‘do no harm’ has always been important to physicians, so as we learn more about the harm of cancer treatment, we try to prevent it.”
Some complications cannot be avoided, but Dr. DeBenedetti said that there are some ways to help protect the heart as the body is going through radiation, chemotherapy and more novel treatments. For example, with radiation, patient breathing techniques and the angle of the radiation beam may lessen the amount of heart tissue that is in the path of radiation. Researchers are also looking into medicines that may help protect the heart during cancer treatment.
Cardio oncology research is small but growing. “Unlike the area of cardiology, where we have many randomized controlled trials, there are not as many trials available for cardio oncology because the number of people with each issue is so much smaller,” explained Dr. DeBenedetti.
In addition to helping patients during their cancer treatment, cardio oncologists see patients both before and after cancer treatment.
“Beforehand, we want to make sure that the heart is as healthy as possible to go through cancer treatment,” explained Dr. DeBenedetti. Cancer and heart conditions are linked by their similar risk factors, including high cholesterol, high blood pressure, obesity and smoking. Therefore, controlling the risk factors for both go hand-in-hand.
“After treatment, radiation and chemotherapy may have damaged the heart, including the muscles and valves, and may accelerate heart conditions such as atherosclerosis and coronary artery disease.”
Cancer survivors with these risks includes those who have had cancer as an adult and as a child. “So many more children are surviving childhood cancers and that’s a wonderful thing, but they do bear some of the scars of the treatment,” said Dr. DeBenedetti.
Although it’s rare that cancer will begin in or spread to the heart itself, knowing how the two are connected leads to safer treatments and more holistic care. To put it simply, the heart needs to be strong and cardio oncology aims to do just that.