Find answers to common questions about heart health and cancer.
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Cancer and heart disease have some of the same risk factors. These shared risk factors include:
- older age
- your sex
- smoking
- diabetes
- physical inactivity
- drinking too much alcohol
- unhealthy diet
- high blood pressure (called hypertension)
- overweight and obesity
- high cholesterol (a type of fat in the blood)
- other chronic inflammatory conditions (e.g. chronic kidney disease).
Making some changes in your day-to-day life can help to lower the risk of heart-related side effects from cancer treatment. Some changes can also reduce the risk of certain cancers.
Heart Foundation has information about looking after your heart.
Some types of cancer treatment can affect how the heart and cardiovascular system work. This is called cardiotoxicity or cardiovascular toxicity.
When working out the best treatment for you, your doctors will try to find a therapy that is effective in treating the cancer while causing the least amount of damage to the heart and blood vessels. You may also be advised to do more physical activity and eat a healthy diet.
Cancer treatments that may be cardiotoxic include:
- certain chemotherapy drugs, particularly anthracyclines (e.g. doxorubicin, daunorubicin, epirubicin) and thymidylate synthase inhibitors (e.g. fluorouracil or 5-FU)
- some targeted therapy drugs (e.g. trastuzumab, bevacizumab, ribociclib, cabozantinib)
- some immunotherapy drugs (e.g. pembrolizumab, nivolumab, CAR T-cell therapy)
- radiation therapy to the chest for some types of cancer (e.g. breast, lung cancers or lymphoma).
These treatments can affect cardiovascular health in different ways.
Some treatments don’t directly affect the heart but can still impact cardiovascular health. For example, certain hormone therapies, such as aromatase inhibitors and androgen deprivation therapy, can increase the risk of high blood pressure, high cholesterol and high blood sugars.
As cancer and heart disease often share risk factors, some people already have heart problems when they are diagnosed with cancer. In these cases, cancer treatments that are potentially cardiotoxic may not be safe. Your doctor may suggest other treatments.
If you’re taking heart medicine, it’s important to keep taking it until you discuss this with your cancer treatment team, cardiologist or cardio-oncologist. Also, let your cancer treatment team know if you have a pacemaker, so they can consider this when planning treatment.
I had heart issues before being diagnosed with cancer (first primary breast cancer then, 9 years later, primary uterine sarcoma). Before starting chemotherapy for uterine sarcoma, my cardiologist and medical oncologist had a big discussion. They decided the planned chemo protocol would be okay.
Cynthia
→ READ MORE: Ways to keep your heart healthy
Podcast: Coping with a cancer diagnosis
Prof Bogda Koczwara, Director, Australian Research Centre for Cancer Survivorship, UNSW, NSW; Prof Aaron Sverdlov, Cardiologist and Co-Director, Newcastle Centre of Excellence in Cardio- Oncology, Hunter New England Health and The University of Newcastle, NSW; Dr Diana Adams, Medical Oncologist, Macarthur Cancer Therapy Centre, NSW; Tamara Casey, Clinical Nurse Consultant, Breast Assessment Unit, Fiona Stanley Hospital, WA; Dr Daniel Chen, Cardiologist and Specialist in Cardio-Oncology, Prince of Wales and St George Hospitals, NSW; A/Prof Eng-Siew Koh, Radiation Oncologist, Liverpool Cancer Therapy Centre, Liverpool Hospital and University of NSW, NSW; Cynthia Leigh, Consumer; Dr David Mizrahi, Senior Research Fellow and Accredited Exercise Physiologist, The Daffodil Centre at Cancer Council NSW and The University of Sydney, NSW; Prof Doan Ngo, Co-Director, Newcastle Centre of Excellence in Cardio-Oncology, The University of Newcastle, Hunter Medical Research Institute, NSW; Peter O’Hearn, Consumer; Prof Nick Pavlakis, Medical Oncologist, Royal North Shore Hospital and Professor of Medicine, The University of Sydney, NSW; Deb Roffe, 13 11 20 Consultant, Cancer Council SA; Dr Lorcan Ruane, Cardiologist, The Prince Charles Hospital, QLD; Margaret Ryan, Nurse Practitioner, Cardio-Oncology Clinic, Prince of Wales Hospital, NSW; Dr Elysia Thornton-Benko, Specialist GP/Primary Care and Cancer Survivorship Physician, NSW; Helen Wardman, Consumer; Dr Trent Williams, Clinical Nurse Consultant, Cardiology, John Hunter Hospital, NSW; Dr Janice Yeh, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; Megan Yong, Consumer.
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