Advances in treatment have improved the chances of survival for young patients with cancer

Over the years, advances in treatment have improved the chances of survival for young patients with cancer. But long-term survivors need to be aware of cancer treatments that may place them at increased risk of heart disease later in life, according to an article in the May issue of Heart Insight, a quarterly magazine for patients, their families and caregivers. Heart Insight is published by the American Heart Association (AHA) and Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Cancer and heart disease survivor Patrick Shaw tells his story to Heart Insight's Mark L. Fuerst. Pat's experience highlights the long-term risk of heart disease for some groups of patients who have been treated for cancer—even years or decades previously. You can read the whole article—along with a special online-only bonus story on assessing the heart disease risk related to radiation therapy for cancer—using the new Heart Insight iPad® app, available as a free download from the iTunes app store.

Lifesaving Cancer Treatment Led to Heart Problems Two Decades Later
Pat was 29 and newly married when he was diagnosed with advanced Hodgkin's lymphoma. Like most young patients with this type of cancer, Pat responded well to aggressive chemotherapy and radiation therapy.

But 20 years later, Pat began having new symptoms—he would wake in a cold sweat in the middle of the night and had little energy on the job and other usual activities. Pat resisted seeing a doctor for a while, but his wife Kim finally convinced him to go to the hospital. At first he was treated for dangerously high blood pressure. But continued symptoms soon led to a diagnosis of coronary heart disease.

Pat's heart disease was a long-term after-effect of his cancer treatment—which included radiation therapy to the chest and treatment with anticancer drugs called anthracyclines. Both treatments are now known to cause long-term damage leading to an increased risk of heart disease later in life. Today, lower doses are used to decrease those risks.

Pat's cardiologist, Dr Ronald Drusin of New York-Presbyterian Hospital, decided that stents to reopen the blocked coronary arteries were a better choice than bypass surgery, because of radiation-induced scarring in Pat's heart. Pat felt better after the procedure, although his recovery was complicated by a stroke.

Today, Pat is grateful to be a "double winner," having beaten first cancer, then heart disease. He pays close attention to his exercise and diet, checks his blood pressure regularly, and takes medications. On weekends he stays busy with his three sons' lacrosse games and other activities. "Pat's prognosis is fine as long as he takes good care of himself, which he does," says Dr Drusin.

Pat thinks he might have saved some "wear and tear" on his body if he hadn't waited to seek medical care for his heart disease symptoms. He hopes others with similar symptoms will see a doctor right away. "You have to be proactive," says Pat. "You are in charge of your own heart."

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