During Breast Cancer Awareness Month, don’t forget to check the heart!

S. Joseph Scott

Special to News Talk Florida

Advances in Breast Cancer therapies have also created new challenges for patients and survivors. Cancer treatments have increased exponentially in their effectiveness. There are more than 3.1 million breast cancer survivors in the United States today. Death rates dropped by 40% from 1989 and 2016. Early detection, better treatment protocols, and increasing awareness have all played an important role in multiplying the number of cancer survivors.

With extended survival rates, however, long term impacts of treatment continue to surface. Many survivors face unexpected side effects from their cancer therapies. Virginia Harrod, captures the issue well explaining, “I beat breast cancer, but the treatment side effects nearly killed me.” One of the most common and most significant late term complications, is heart damage. Chemotherapy drugs and radiation, particularly when targeted at the breast, are toxic to the cardiovascular system.

These observations have birthed a promising new field of study and treatment called “cardio-oncology.” Cardio-oncology is, as its name implies, the intersection between cancer treatment and cardiovascular disease. It brings together both cardiologists and oncologists to optimize cancer therapies while seeking to minimize damage to the cardiovascular system. Cardio-Oncology was introduced as a unique discipline about ten years ago and has grown rapidly on an international scale.

This month over 500 physicians from a host of related disciplines including cardiology, oncology, and radiology from 17 countries gathered in Sao Paulo, Brazil to share the latest research, discoveries, and new treatment protocols in cardio-oncology. The annual global gathering of the International Cardio-Oncology Society (IC-OS.org) has attracted increasing interest since its inception in 2015. Most of the major medical schools in the US now have cardio-oncology training as part of their programs.

Despite the rapid growth of the discipline, however, awareness remains a challenge. Tomas G. Neilan, MD, director of the cardio-oncology program at Massachusetts General Hospital in Boston observes, “I’ve had recent conversations with cardiologists who said ‘I’m not sure what cardio-oncology is.’” Daniel J. Lenihan, MD, President of the International Cardio-Oncology Society suggests that, “The number one priority for cardio-oncology is to raise awareness about it at every level: patients, their support people, oncologists, cardiologists, and primary care physicians.” The objective is, of course, better care for cancer patients and survivors.

Greater collaboration between oncologists and cardiologist before, during and after treatment is needed. One recent study revealed that only 15% of patients were encouraged to consult a cardiologist prior to receiving chemotherapy. Many breast cancer patients are unaware of the long term impacts their treatment may have on their quality of life. There are oncologists who work closely with cardiologists during treatment and follow up, but still too few. The future of breast cancer therapy, as with all cancer therapies, is cross-disciplinary in nature.

As with most medical matters, knowledge is power. Laura Landro in her memoir, “Survivor,” explains that as a cancer patient and reporter, “I learned that the only way to figure out the right questions was to do my homework beforehand. Knowledge, while terrifying, is power.”

Fortunately, the internet puts information a click away. Some of that information is very technical but much is accessible to patients. When Laura Landro was diagnosed with cancer, she researched options and that equipped her with the knowledge to ask intelligent questions about her treatment. You can do the same, and one important question to discuss with your doctor is the cardiovascular risks associated with your treatments.

This is particularly important for those who have previously existing heart disease. “I refer [to a cardiologist] any patient with a cardiac history,” comments Sandra M. Swain, MD, professor of medicine and associate dean for research development at Georgetown University in Washington.

“I would suggest an individual diagnosed with breast cancer ask their providers about how cancer treatments may impact their heart,” suggests Dr. Anne Blaes, Associate Professor of Medicine from the University of Minnesota. She also encourages those undergoing breast cancer therapy to “be aggressive about managing cardiac risk factors.” Dr. Blaes gives this simple and pointed advice, “exercise! We know women who exercise at least 150 min per week of moderate intensity exercise live longer, have less recurrence, and have less cardiovascular complications.” If you are a Breast Cancer patient or survivor, be sure to consult with a cardiologist. There are therapies that can limit cardiovascular disease even after treatment. This Breast Cancer Awareness month comes with a related warning. Don’t forget to check the heart!

S. Joseph Scott has a Ph.D. in theology and has served in leadership positions in both higher education and religious institutions. He has published in both academic and popular journals and has a special interest in the intersection of faith and culture.