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I think it’s important for cancer patients and survivors to become familiar with the possible side effects of chemoradiation to the heart.
What side effects to the heart are caused by chemoradiation?
1. Radiation-Induced Heart Disease (RIHD)
Radiation therapy, especially to the chest, can damage heart tissues over time. This damage may manifest years after treatment and can affect different parts of the heart, including the heart muscle, valves, arteries, and pericardium (heart’s lining).
Coronary artery disease: Radiation can cause the coronary arteries to stiffen and narrow, increasing the risk of heart attacks.
Pericarditis: Inflammation of the pericardium, leading to chest pain and fluid accumulation around the heart (pericardial effusion).
Valvular disease: Radiation may cause thickening or stiffening of the heart valves, leading to regurgitation or stenosis.
Cardiomyopathy: Damage to the heart muscle itself can lead to reduced heart function and heart failure.
2. Chemotherapy-Related Cardiotoxicity
Some chemotherapy agents are known to be cardiotoxic, causing direct damage to heart muscle cells or altering heart function.
Anthracyclines (e.g., doxorubicin): These drugs are particularly known for causing cardiomyopathy, which can lead to heart failure. The risk is dose-dependent and increases with cumulative exposure.
Herceptin (trastuzumab): Used in HER2-positive breast cancer, this drug can cause heart dysfunction, especially when combined with anthracyclines.
Tyrosine kinase inhibitors: These drugs can lead to hypertension and heart failure in some patients.
Fluoropyrimidines (e.g., 5-FU, capecitabine): These can cause coronary artery spasms, leading to angina (chest pain) or even heart attacks.
3. Arrhythmias
Both radiation and certain chemotherapy agents can disrupt the electrical conduction system of the heart, leading to irregular heartbeats (arrhythmias), such as atrial fibrillation or ventricular arrhythmias.
4. Hypertension
Chemotherapy drugs like bevacizumab (Avastin) and tyrosine kinase inhibitors may cause or worsen high blood pressure, which can strain the heart over time.
5. Heart Failure
Chemoradiation can weaken the heart’s ability to pump effectively, leading to symptoms of heart failure such as shortness of breath, fatigue, and swelling in the legs.
6. Thromboembolic Events
Chemotherapy increases the risk of blood clots, which can cause deep vein thrombosis (DVT) or pulmonary embolism (PE). If clots travel to the heart or lungs, they can cause serious complications.
Risk Factors
Pre-existing heart conditions: People with pre-existing cardiovascular disease are at higher risk of developing heart problems from chemoradiation.
Higher radiation doses: The risk of radiation-induced heart disease increases with higher doses of radiation.
Age: Older patients tend to have a higher risk of cardiac side effects.
Concurrent use of cardiotoxic drugs: The combination of certain chemotherapeutic drugs can exacerbate the risk of heart damage.
Monitoring and Prevention
Echocardiograms: Used to assess heart function before, during, and after treatment.
Cardiac biomarkers: Troponin and BNP levels can help detect early signs of heart damage.
Medications: ACE inhibitors, beta-blockers, or other heart-protective drugs may be used to prevent or treat cardiotoxicity.
Lifestyle modifications: Encouraging a heart-healthy lifestyle, including diet and exercise, may help mitigate the risks.
Despite all of the damage that chemoradiation can do to a cancer patient’s heart, conventional medicince’s treatment plan is more toxic therapies-
I think its even more remarkable that I have maintained my heart health since late 2010 through
heart healthy nutrition
supplementation and
lifestyle therapies.
I don’t undergo any conventional heart meds. None. If you’d like to learn more about how to manage your heart health once you’ve undergone chemoradation, email me at David.PeopleBeatingCancer@gmail.com
“Results: A total of 14,600 patients were analyzed. Compared to non-cancer patients (n = 6,801), cancer patients (n = 7,799) had a significantly higher prevalence of AF (4.3 vs. 3.1%; p < 0.001).
However, following correction for covariates in a multivariable logistic regression model, malignancy was not found to be an independent risk factor for AF (p = 0.32). While patients with solid tumors had a numerically higher prevalence of AF than those with hematological malignancies (4.3 vs. 4.1%), tumor type was not independently associated with AF (p = 0.13).
AF prevalence was higher in patients receiving:
chemotherapy (4.1%),
radiation therapy (5.1%),
or both (6.9%)
when compared to patients not receiving any therapy (3.6%, p = 0.01).
On multivariable logistic regression, radiation therapy remained an independent risk factor for AF for the entire study population (p = 0.03) as well as for the cancer population (p< 0.01).
Conclusions: Radiation therapy for cancer is an independent risk factor for AF. The known association between cancer and AF may be mediated, at least in part, by the effects of radiation therapy…
Conclusion
In conclusion, results from our study add to the growing evidence in the literature that AF is more prevalent in cancer patients. This association could be related to the co-morbidities of cancer patients or other mechanisms related to the cancer and/or chemoradiotherapy. In addition, our study offers new evidence that radiation therapy for cancer is associated with an increased risk for AF. Chemoradiation increases the risk of atrial fibrillation.
Further study is needed to evaluate this association.