Do cancer treatments increase a patient's risk of cardiovascular disease?
Although advances in cancer treatments have decreased cancer mortality over the past decade, there are now a growing numbers of cancer survivors experiencing long-term effects related to those therapies. The heart is especially vulnerable to inflammation triggered by cancer and toxic effects from chemotherapy and radiation therapy, which has given rise to cardio-oncology clinics.
A new study in the journal Cancer looked at the cardiovascular disease incidence in older cancer survivors and the impact of specific cancer treatments on heart health.[1] Researchers found higher risks of stroke, heart attack and hospital admission for heart failure in older cancer survivors and linked chemotherapy to elevated rates of these conditions.
“Our research contributes to the growing body of work indicating that cancer- and treatment-related cardiovascular disease is a very real risk in cancer survivors,” explained lead researcher Suzanne Orchard, PhD, director of the ASPirin in Reducing Events in the Elderly (ASPREE) Clinical Trial at Monash University in Australia, in a statement. “Cardiovascular disease can have a significant impact on both quality of life and survival for patients with cancer. Fortunately, with early screening and preventative measures, some of the cancer-related risks can be mitigated.”
Orchard analyzed data from the ASPREE trial, which included adults aged 70 years and older who were living in Australia and the United States.
Of the 15,454 participants, 1,392 developed cancer over an average follow-up of 4.6 years. When the researchers assessed which participants experienced a cardiovascular disease event including stroke, heart attack, or hospital admission for heart failure, they found that the rate was twice as high in those who developed cancer compared with those who were cancer-free. The data shows cancer patients had an average of 20.8 cardiovascular disease events among 1,000 people over one year, as compared to only 10.3 events in the patients who did most have cancer.
This elevated risk remained even after accounting for traditional cardiovascular disease risk factors.
The incidence of cardiovascular disease events was greatest in patients with metastatic, blood and lung cancers. Also, chemotherapy was associated with a two-times higher risk of cardiovascular disease events.
Analyses were inconclusive regarding other systemic therapies such as hormonal therapy, targeted therapy, immunotherapy, and radiation therapy—although thoracic radiation is known to confer an elevated risk. Aspirin (the intervention in the trial) did not impact cardiovascular disease incidence.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com