Cardio-oncology – how to overcome the cancer and save your heart
The cancer changes not only a patient being, but it also affects his relatives’ lives. But what happens if, in addition to an oncological problem, a second, no less dangerous disease manifests itself? About 20% of people, who experience cancer also suffer from heart diseases, which are side effects from cancer treatment. Because of this fact, Cardio-oncology, a new direction in the medicine of Israel, has developed.
In recent years, it has been found out that a significant number of patients who suffer from cancer also experience heart and blood vessels diseases. This issue helped Cardio oncology, a new direction of medicine, to mature. Cardio-oncology is a combination of cardiology (treatment of heart diseases) and oncology (treatment of malignant neoplasms). Despite its novelty, this direction has gained immense popularity in the main clinics of Israel, in some of which specialized cardio oncology departments have been opened.
Oncological and cardiovascular diseases are leading causes of death in developed countries. High progress in medicine has caused a notable change in the demographic profile of the population, increase in life expectancy and, accordingly, a high probability that both of these medical problems will affect the same person simultaneously.
The research published by cardiologists of the University of Texas proves, that in 20% of cancer illnesses, adults suffer from cardiac pathology as well.
A great emphasis should be put on such cardiac diseases as coronary heart disease (coronary insufficiency), cardiomyopathy (structural change of the heart muscle), and arrhythmias (cardiac arrhythmias). Treatment of cancer includes several elements of radiotherapy that can lead to the defeat of the myocardium and heart membranes, as well as drug treatment (chemotherapy), which has a cardiotoxic effect. Cancer treatment can lead to a cardiovascular pathology or aggravate the symptoms of a previously existing disease. However, the reversed connection was also found: in a large study that included the observation of 9,203 patients, who suffer from heart insufficiency, a considerable risk of suffering from cancer in the earliest future was found, which exceeds the probability of suffering from cancer in a healthy population by 68%.
The cause of heart diseases: cancer treatment
The main cause of cardiovascular pathology of patients who undergo cancer treatment is the damage to the inner shell of the coronary vessels (endothelium) caused by the action of ionizing radiation on the heart and chest region (as, for example, in cases of breast cancer or Hodgkin's lymphoma). The research conducted by scientists of the University of Florida has shown that 10% of patients who have received mediastinal irradiation had cardiac problems that developed on average 9 years after the treatment. Currently, modern methods of radiotherapy are used, which make it possible to substantially reduce the radiation dose, as well as to maximize the accuracy of the direction of the rays. Probably, in some years, we will be able to observe significantly less late side effects that are caused by irradiation of the heart.
Another vital factor in the development of cardiac diseases is chemotherapy. Most of the antitumor drugs in low doses do not cause a pronounced effect on the heart; however, with an increase in dosage, the risk of cardiotoxic side effects increases. Of particular importance is the characteristic of antitumor drugs to cause a pronounced reduction in coronary arteries, which increases the risk of myocardial ischemia, sometimes even until the development of a heart attack.
Cancer or heart disease: what to treat earlier?
With no doubt, treatment of heart diseases that directly threatens a patient's life is a priority. However, patients suffering from oncological diseases cannot receive the necessary cardiac care in full quantity. For example, a treatment that is aimed to restore coronary circulation in ischemic heart disease can provoke dangerous bleeding in patients who suffer from cancer. Also, no exceptions are given to invasive methods of treatment, after which prolonged use of anticoagulants is required. The most optimal solution is a joint treatment program developed by oncologists and cardiologists within the framework of specialized cardio-oncological centres, which considers the individual characteristics of the course of both diseases.
Specialists from Herzliya Medical Center are practicing an individual approach and developing a personalized treatment plan based on the latest developments and innovations.