Breast cancer chemo raises heart risks
October 21, 2007 10:49am CST
New research shows the adage "what doesn't kill us makes us stronger" doesn't apply in treating breast cancer. A study published in the October 9 issue of the Journal of the American College of Cardiology has found certain treatments that cured breast cancer made women more susceptible to heart disease. "We always felt the benefit of savings lives outweighed the risks and were just part of the accepted cost," says Pamela S. Douglas, M.D., chief of cardiology at Duke University and co-author of the JACC paper. But with the success of treatment and growing survivor numbers, Douglas and her colleagues are urging doctors to take the long view when deciding on a woman's breast cancer treatment. First treat the cancer, but don't forget about cardiovascular health down the road. The spike in heart disease risk comes from a variety of sources. Chest radiation, lack of exercise during treatments and stress are all part of the heart-hurting connection. But according to Douglas, the greatest damage comes from a breast cancer treatment mainstay --chemotherapy. Specifically, researchers are looking at chemotherapy medicines called anthracyclines. These compounds are used to treat a variety of cancers, including leukemia, lymphomas, uterine, ovarian and breast cancer. They are also known to harbor a well-known risk: They weaken some women's hearts. "There are other drugs that are less harmful, and we know a little bit about how to lower the doses" says Douglas, but it's too soon to start completely overhauling breast cancer therapy, she says. Instead, doctors and organizations including the National Breast Cancer Coalition are calling for more research into cancer treatments to see whether other drugs might yield the same result without the added long-term risk. Douglas also stresses that it is important to look at all the factors surrounding a woman's condition, as patients are "taking hits from multiple places." While the cancer therapy might be one source of added cardiovascular risk, diet, weight and family history also play a major role. Her advice to patients who learn they have breast cancer, "First get cured!" But she adds: "Take seriously the consequences that dieting and regular exercise can have for your health while taking something that is not necessarily heart healthy." Her words offer a stark reminder that treatment for cancer is still a careful balancing act of medicine working together with lifestyle.
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