Caring for your Heart
We all know that cancer and heart disease are the two biggest killers of Americans. Aren't we "lucky" to possibly have the opportunity to experience both? As cancer treatments have become more targeted and sophisticated, there have been more drugs that may negatively impact the heart.
For a long time, attention has been paid to cardiac function before initiating some therapies (e.g. Adriamycin)There is a safe life time limit for that and some other drugs, and, if someone is on Adria for a long stretch, periodic cardiac tests are ordered. There are newer drugs, e.g. herceptin, that may also damage the heart. As people live longer post cancer, there may be concern about damage caused by radiation that touched the heart. The good news is that oncologists and cardiologists are increasingly working together and developing strategies to try to keep both cancer and heart disease at bay.
This is a good and sobering article from Medscape:
A New Oncology Target: The Heart
For decades, oncologists have carefully stepped around their cardiologist colleagues and aimed ever-increasing numbers of toxins at tumors. Oncologists then regretfully watched the unintended effects on the heart. The oncologist's traditional goal was to make the patient cancer-free, leaving cardiologists to do the cardiac damage control. But the now-blossoming field of cardio-oncology is taking a different approach.
Recognizing that cardiotoxic drugs are essential in the fight against cancer—and even that adverse cardiac effects may sometimes be a favourable prognostic indicator in oncology—the field of cardio-oncology has emerged with a quest to collaborate.
The goal is to maintain the momentum against cancer while keeping the health of the heart in central focus.
"We are trying to understand the synergism between cardiovascular risk factors, cancer, and cancer-treatment cardiac effects,"
said Ana Barac, MD, PhD, director of cardio-oncology at Georgetown Hospital and current chair of the American College of Cardiology's cardio-oncology council, speaking at a special session at the American Society of Clinical Oncology (ASCO) annual meeting.
That goal is a moving target, with new cancer drugs in new combinations and new regimens emerging almost daily. Adding to this challenge is the graying population of cancer survivors for whom the aging heart provides yet another layer of complexity in the management of cardiotoxic risk.