Women who overcome breast cancer have every reason to celebrate. But a heart filled with joy may also be a heart damaged by life-saving cancer therapies, a growing body of research shows.
“Most breast cancer therapies today – including new treatments still under development – increase long-term risk of cardiovascular disease,” said Lee W. Jones, Ph.D., an exercise physiologist and assistant professor in the Department of Surgery at Duke University Medical Center, Durham, NC. “We don't know exactly how large the added risk is, but we believe it's substantial. Recent gains in breast-cancer-specific survival could be markedly diminished by an increase in the long-term risk of cardiovascular death.”
In an article published in the October 9, 2007, issue of the Journal of the American College of Cardiology (JACC), Dr. Jones and his colleagues call for taking the long view in breast cancer therapy—focusing not just on the immediate cancer threat but also on long-term cardiovascular health.
“There are millions of American women living with breast cancer,” said Pamela S. Douglas, M.D., chief of cardiology at Duke and a co-author of the JACC paper. “It's important that they don't squander their second lease on life.”
Breast cancer is the most common form of cancer among American women, accounting for more than 200,000 new cases each year. Thanks to new and better therapies, death rates from breast cancer are falling dramatically—by nearly 24 percent between 1990 and 2000, for example. That means that more women than ever before will live for years with the cardiovascular effects of cancer therapy.
Many middle-aged and older women who are diagnosed with breast cancer already have age-related risk factors for cardiovascular disease, such as high blood pressure. In addition, physical inactivity and obesity have been linked to both breast cancer and heart disease. This pre-existing risk only heightens the likelihood that breast cancer therapies will harm the cardiovascular system.