Cardiotoxicity-Chemotherapeutics

Cardiotoxicity is damage to the heart caused by certain cancer treatments or drugs. It can occur years after cancer treatment, especially in adults who were treated for cancer in childhood. Certain cancer treatments are associated with an increased risk of cardiotoxicity. It is more common in people who have received specific chemotherapy or targeted therapies. It can also occur in people who have received radiotherapy to the chest area.

Cardiotoxicity can cause the heart to stop pumping blood around the body as well as it should. In severe cases, it can lead to cardiomyopathy, which is a disease of the heart muscle that makes it difficult for the heart to pump enough blood.

Cardiotoxicity can occur in anyone receiving cancer treatment. It is more likely to occur in people who have taken certain drugs or received radiotherapy to the chest area.

It is also relatively common in adults who received cancer treatment as a child. It is difficult to determine the exact rate of cardiotoxicity in adults who received cancer treatment as adults. However, some groups estimate that up to 20% of this population may develop heart problems, with 7-10% experiencing cardiomyopathy or heart failure.

Certain cancer therapies can cause cardiotoxicity:

Anthracyclines such as doxorubicin (Adriamycin®), chemotherapy drugs commonly used to treat leukaemia, lymphoma, breast cancer, sarcoma or multiple myeloma.

Trastuzumab (Herceptin®), a targeted therapy that is often used to treat breast cancer, stomach cancer or cancer of the gastro-oesophageal junction (oesophagus) to the stomach. This drug is most likely to cause cardiomyopathy when combined with an anthracycline.

Radiotherapy to the chest, which is often used to treat breast cancer or leukaemia.

Dr Konstantinou can diagnose cardiotoxicity by measuring the pumping function of your heart using the left ventricular ejection fraction (LVEF) and assessing the function of your heart valves.

A strain analysis is also carried out to detect damage to the heart at an early stage. This analysis is a modern AI-supported procedure that must be carried out at regular intervals during ongoing chemotherapy. It is important that this analysis is carried out before the start of chemotherapy. This very first analysis serves as a comparison in order to recognise possible future damage at an early stage and treat it accordingly.

Dr Konstantinou, in consultation with your oncologist, may recommend that you discontinue certain medications or reduce the dose, depending on the medications you are currently taking.

He may also prescribe medication to help your heart work more efficiently, such as

• ACE inhibitors

• beta blockers

• diuretics

• vasodilators.

Cardiotoxicity cannot be prevented. If you have been diagnosed with cancer, it is important that you talk to your doctor about the potential health risks and benefits of treatment. So-called side effect management is certainly useful to prepare for possible adverse events.

You can increase your chances of early detection of cardiotoxicity if you undergo regular heart examinations during your cancer treatment. Early detection of heart problems can increase your chances of successful treatment.