Study: Adult cancer survivors at greater risk of heart disease

February 24, 2016 | by Denise Heady

Cardiovascular disease (CVD) – also commonly known as heart disease – is a genuine concern for many Americans. With more than 600,000 heart disease-related deaths expected this year, it continues to be the leading cause of death nationwide. But cancer survivors may be at even greater risk. 

According to a new study by City of Hope researchers published this month in the Journal of Clinical Oncology, adult cancer survivors are at higher risk of CVD because of treatment side effects and other lifestyle factors. 

To combat this, City of Hope scientists are investigating ways of reducing the long-term physical toll of chemotherapy, radiation and other cancer treatment on the heart. 

“Until now, very little was known about the cardiovascular health of adult, long-term cancer survivors,” said lead author Saro H. Armenian, D.O., M.P.H., associate professor in the departments of Pediatrics and Population Sciences at City of Hope. “The findings from the study highlight the significant morbidity associated with cardiovascular complications, emphasizing the need for closer surveillance and monitoring in certain populations who may be at high risk of developing CVD.”

City of Hope researchers had already found that cardiovascular diseases, such as ischemic heart disease, stroke and heart failure are a leading cause of illness and death in adult survivors of childhood cancer. Researchers have now confirmed similar findings in cancer survivors diagnosed at age 40 and older, particularly survivors of multiple myeloma, non-Hodgkin lymphoma, lung cancer and breast cancer.

“These findings reinforce that these risks apply to adults, too, and also suggest that millions of aging cancer survivors need to pay closer attention to lifestyle choices that could help avert cardiovascular disease,” Armenian said in an interview with Reuters Health.

Saro Armenian Saro H. Armenian, D.O., M.P.H

To study the possible link between CVD and cancer, Armenian and his colleagues analyzed medical records of patients who were diagnosed with cancer between 2000 and 2007, were at least 40 years old at the time and who had survived at least two years since the initial diagnosis. The researchers followed this group of patients until they developed CVD or died, or until the study ended in 2012.

What they discovered is that patients diagnosed with multiple myeloma, non-Hodgkin lymphoma, breast, kidney, lung/bronchus or ovarian cancer had as much as a 70 percent higher risk of CVD when compared to someone who had not been diagnosed with cancer. 

“While the reasons for these findings are not yet clear,” said Armenian, “it is possible that the presence of CVD can markedly diminish treatment options or planned duration of therapy at the time of cancer recurrence, thus compromising the optimal long-term management of a cancer patient.”

With more than 14 million cancer survivors living in the U.S. today — a number expected to grow to 19 million by 2024 — Armenian said that larger studies are needed to evaluate the efficacy of comprehensive interventions designed to lower long-term CVD risk, with its attendant morbidity and mortality. It’s a research gap that he and his colleagues are eager to fill.

“In the coming year, we plan to systematically interrogate the treatment-related as well as other modifiers of CVD risk in these populations and to explore the interactions between cancer-directed therapies and health-related co-morbidities,” he said.

Cancer survivors may reduce risk of heart disease with these lifestyle changes, from the National Institute of Health:

  • Follow a heart-healthy diet by reducing consumption of red meat, sugary foods and beverages, alcohol, palm and coconut oils, and high-sodium foods. Instead, opt for fruits and vegetables, fish high in omega-3 fatty acids, whole grains, and fat-free or low-fat dairy products.

  • Maintain a healthy weight through regular exercise and healthy eating. Determining your body mass index, or BMI, can help you find your optimal weight in relation to your height. 

  • Manage stress and get plenty of sleep to improve your physical and mental health. Stress-reducing activities such as meditation, exercise and spending time with friends and family can help. 

  • Stay physically active with low- to moderate-intensity activities, such as brisk walking. Routine physical activity can lower many CVD risk factors, including high blood pressure and excess weight. If you have physical limitations, be sure to consult your doctor first.

  • If you smoke, quit. Smoking can increase risk for heart disease and worsen other heart disease risk factors.   

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If you are looking for a second opinion or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.

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