Heart health during cancer treatment

Cancer treatment in Australia has come a long way in the last few decades - currently at a 69 per cent, five-year relative survival rate for all cancers combined, however cancer treatments can leave patients with ongoing issues affecting the heart.

Generally, cancer is treated using a variety of methods including surgery, chemotherapy, radiotherapy, immunotherapy, theranostics and targeted therapies.

These treatments can be challenging for patients, with commonly known side effects such as hair and weight loss, pain and changes to taste and smell.

Radiotherapy to the chest increases the risk of cardiovascular damage, as do many forms of chemotherapy, targeted therapy and immunotherapy.

There are also some cancer conditions such as neuroendocrine tumour with carcinoid syndrome for which patients should have their hearts monitored very carefully.

Following cancer treatment if heart conditions are looked for and intervened early, the problems may often be reversed. The later they are picked up and acted upon the less chance of recovery.

Cardio-oncology is a clinically based discipline focused on the cardiovascular health of cancer patients and cancer survivors.

By identifying and treating chronic conditions such as hypertension and diabetes and introducing lifestyle programs and medications, if necessary, to lower the risk of heart disease, the patient is managed to avoid cardiac issues or detect them early if they occur. It is a complex area with lots of different cancer therapy regimes having cardiac implications and many cancer patients reaching remission with no heart issues.

If permanent damage to the cardiovascular system does occur as part of cancer treatment, the patient may just need medications but there are other interventions such as pacemakers or defibrillators, surgery and in rare cases, transplant.

The outlook for cardio-oncology in Australia is bright, but it is still in its infancy. We are not a world leader but we are a world player and there is a big focus on doctor and patient education, training of interested cardiologists in this field, contribution to research and new treatments.

Heart health is a serious matter regardless of its effects on cancer patients. Heart disease is the leading cause of death in Australians, and yet also the most preventable. Other conditions that may contribute to cardiac issues include things like smoking, obesity, high blood pressure, high cholesterol, diabetes and a family history of cardiac disease.

Through lifestyle changes and management with your health care professional, you can reduce your risk of developing heart disease through a healthy diet, regular exercise regime, and possibly medication.

Exercise: Aim for 2.5 hours a week of moderate-intensity exercise with muscle strengthening exercises on two days a week.

Diet: Consume a healthy diet of fresh produce, vegetables, fruits, nuts, fish, seed-based products and avoid highly-processed foods.

The Heart Foundation website (www.heartfoundation.org.au) has resources on disease prevention, but you can discuss personalised care with your GP.