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Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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Long-term Myeloma Heart Damage
Should long-term myeloma survivors worry about heart damage? According to the research linked below, yes, they should.
Myeloma patients are older on average and may have heart issues regardless of their MM. Myeloma patients undergo many of the therapies listed below, that can caused heart damage.
Average life expectancy has improved over the past dozen years or so. The longer that MM patients live, the more likely they are to diagnosed heart damage.
Which treatments commonly used with multiple myeloma can cause heart damage?
Some treatments for multiple myeloma can affect the heart as a side effect. These include:
- Proteasome Inhibitors:
- Carfilzomib (Kyprolis): Can cause or worsen heart failure, hypertension, and ischemic heart disease.
- Bortezomib (Velcade): While less cardiotoxic than carfilzomib, it may still contribute to cardiac complications, including arrhythmias or heart failure, in some patients.
- Immunomodulatory Drugs (IMiDs):
- Lenalidomide (Revlimid) and Pomalidomide (Pomalyst): Can increase the risk of blood clots, which may lead to heart-related issues, such as myocardial infarction.
- Thalidomide: Has a higher risk of blood clots and peripheral neuropathy, which indirectly can stress the cardiovascular system.
- Anthracyclines:
- Doxorubicin: Used less commonly in multiple myeloma now, but historically a mainstay in chemotherapy, it is associated with dose-dependent cardiotoxicity, including heart failure and cardiomyopathy.
- High-dose Chemotherapy with Stem Cell Transplant:
- High-dose melphalan, used as conditioning before an autologous stem cell transplant, can indirectly strain the heart due to its overall impact on organ function and stress on the body.
- Monoclonal Antibodies:
- Daratumumab (Darzalex): Though generally well-tolerated, infusion-related reactions can include hypotension or other cardiac-related symptoms.
- Steroids:
- Dexamethasone: Often used in multiple myeloma, it can lead to hypertension, fluid retention, and arrhythmias, particularly in long-term use.
- Bisphosphonates:
- Medications like zoledronic acid or pamidronate, used to manage bone disease in multiple myeloma, can sometimes cause atrial fibrillation or affect the heart rhythm indirectly.
What is chemotherapy-induced cardiomyopathy?
Full disclosure- I was diagnosed with chemotherapy-induced cardiomyopathy almost exactly 15 years after my autologous stem cell transplant.
I had a reaction to metoprolol. I have been living a heart healthy lifestyle with:
- heart healthy nutrition
- heart healthy supplements
- heart healthy lifestyle
Conventional oncology recommends monitoring of cancer survivors and heart therapies during treatment. That’s fine.
My approach was to undergo as many evidence-based non-conventional heart therapies as possible. My echo metrics have all stabilized or improved.
The solution is twofold- read the post linked above to learn about heart healthy supplementation and talk to an experienced cardio-oncologist.
Email me at David.PeopleBeatingCancer@gmail.com with questions about your heart health.
Thanks,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Diastolic dysfunction and risks of heart failure and death in long-term adult cancer survivors
Discussion
Our analysis focused on the prevalence of diastolic dysfunction and its prognostic significance in long-term cancer survivors. This study reveals several key findings.
- First, among long-term adult cancer survivors, the prevalence of diastolic dysfunction was higher than that of systolic dysfunction, but both were comparable to the prevalence in matched non-cancer controls.
- Second, there was a graded increase in the risk of adverse outcomes with worsening diastolic dysfunction.
- Third, specific diastolic parameters demonstrated a dose–response relationship with outcome risks. Notably, the thresholds for increased risk differed from those established by traditional guidelines for the general population…
Prevalence of cardiac dysfunction in long-term cancer survivors
Diastolic dysfunction was one of the most common echocardiographic abnormalities in cancer survivors. According to the 2016 ASE/EACVI guidelines [18], the prevalence of indeterminate diastolic function in cancer survivors was 22.88%, while 12.26% had diastolic dysfunction.
However, when using the three-parameter algorithm, the prevalence of abnormal diastolic dysfunction increased to 29.32%. This suggests that the heterogeneity and ambiguity of different definitions can lead to significant variability in the reported prevalence of diastolic dysfunction.
However, even when using the same diagnostic criteria in similar populations, the prevalence can vary substantially. For instance, the reported prevalence rates range from 1.4 to 3.1% in populations with a mean age in their 60 s [26, 27] and from 9.4 to 36.1% in those with a mean age in their 50 s [28, 29].
Thus, although our study did not find a significant difference in diastolic dysfunction prevalence between long-term cancer survivors and matched non-cancer controls, the possibility of a higher prevalence in cancer survivors remains uncertain. Multi-center studies with larger, more diverse samples may help ensure a more accurate and generalizable prevalence estimate…
Several mechanisms may account for the lower thresholds observed in cancer survivors. Cancer treatments, such as chemotherapy and radiation, can directly damage cardiac tissue, leading to early onset of diastolic dysfunction [35]. Additionally, factors like chronic inflammation, immune dysregulation, and oxidative stress related to cancer itself may further exacerbate this condition [36]…
long-term myeloma heart damage
long-term myeloma heart damage