In a new installment of the series Beyond the Tumor: Answering Questions on Ovarian and Breast Cancer, organized by IVOQA and AMOH Asociación, Dr. Sergio García Ortego, cardiologist at Viamed Santa Elena University Hospital, addresses a crucial but often overlooked issue: the effects of chemotherapy on cardiovascular health. These complications fall under the field of cardio-oncology, an emerging discipline that combines oncology and cardiology expertise to provide comprehensive and safe care.
What is chemotherapy-induced cardiotoxicity?
Cardiotoxicity is a potential side effect of certain cancer treatments, particularly some types of chemotherapy and targeted therapies. It refers to the damage these drugs may cause to the heart, impairing its function and increasing the risk of developing cardiovascular disease. This effect may appear acutely during treatment or manifest later, even years after cancer therapy has ended.
Which treatments can affect the heart?
The treatments most strongly associated with cardiotoxicity include:
- Anthracyclines (such as doxorubicin)
- Trastuzumab (used in HER2+ breast cancer)
- Immune checkpoint inhibitors
- Chest radiotherapy when the cardiac area is involved
These treatments can lead to a range of complications, from mild ventricular dysfunction to heart failure, arrhythmias, or hypertension. For this reason, it is essential to monitor cardiac function before, during, and after cancer therapy, especially in patients with breast cancer, lymphoma, or other tumors requiring aggressive treatment regimens.
How can heart damage be prevented?
Dr. García Ortego highlights the importance of cardiology assessment prior to initiating cancer treatment, particularly in patients with cardiovascular risk factors. Preventive strategies include:
- Monitoring with echocardiograms before, during, and after treatment
- Using cardiac biomarkers (such as troponins or BNP) to detect early damage
- Controlling risk factors: managing blood pressure, cholesterol, diabetes, and quitting smoking
- Prescribing cardioprotective medications in selected patients
These measures are part of current preventive cardio-oncology protocols, designed to minimize adverse cardiovascular effects without compromising the effectiveness of cancer treatment.
