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Breast Cancer Patients Need Better Cardiology Care

As cancer therapy becomes more effective and the number of cancer survivors increases, doctors and patients need to be asking questions about heart health, according to the experts at the University of Michigan Comprehensive Cancer Center.

More than two million breast cancer survivors in the United States are believed to be at risk for cardiotoxicity (when cancer drugs have toxic effects on the heart). Heart problems linked to cancer treatment include heart failure, chemotherapy-induced hypertension, arrhythmias, thromboembolism (blood clots) or cardiac ischemia, a sudden severe blockage of a coronary artery that can lead to a heart attack.

Preventing heart disease in cancer patients continues to be a concern as more aggressive cancer therapies are used on older patients who may already have heart disease, and researchers identify a growing number of cardiovascular side effects of anti-cancer therapy.

Doctors at the University of Michigan and elsewhere are working to make both doctors and patients more aware of the need to monitor heart health during treatment.

“The goal of the collaboration between cardiologists and oncologists is to eliminate cardiovascular complications as a barrier to effective treatment of cancer patients, by providing prevention and early detection of cardiac complications, cardiovascular monitoring during anticancer therapy, and therapy of cardiovascular disease that develops during chemotherapy,” said University of Michigan cardiologist Elina Yamada, M.D.

Research is underway at the U-M Comprehensive Cancer Center to further reduce radiation exposure to the heart during treatment as well as look at ways to reduce cardiotoxicity.

"The diagnosis of cardiac problems during cancer treatment can be difficult based on symptoms alone, as some of them, such as fatigue, shortness of breath and swelling, can be caused by the adverse effects of chemotherapy. Therefore, when patients present with these symptoms, it is important to have cardiac evaluation," said Yamada.

Scientists in cardiology and oncology will be a part of the cardio-oncology program at the university, working to better understand the mechanisms of cardiotoxicity at the cellular level, and participating in new chemotherapeutic drug studies with the goal of minimizing cardiotoxicity in future cancer drugs.

"Our goal will be early detection and to protect patients with heart medications," said U-M cardiologist Monika Leja, M.D.

Patients can do some things on their own, said the researchers, to avoid potential heart trouble during cancer treatment, such as eating a low-cholesterol diet, getting regular exercise, avoiding obesity, and controlling blood pressure and blood sugar.

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