TIME Cancer

The Serious Heart Risks That Come With Chemo

Certain classes of drugs—often used in breast cancer treatment—have possibly fatal side effects. Cardio-oncologists are on the case

When you hear you have cancer, you get tunnel vision—and so might your oncologist. Together, you want to annihilate this invader. And together, you select a treatment that’ll give you the best shot. If there’s a warning about the potential side effects of your cancer cocktail, it probably sounds like a whisper to you, because, come on—you have cancer. That’s how Kim Sander, 54, felt when she was first diagnosed with one of three bouts with breast cancer. “I just wanted my cancer to go away, that’s all I was thinking about,” she says. Eventually, Sander’s doctors discovered she had severe muscle damage caused by the very drugs that were saving her life.

Stephanie Cirilo, 57, has a similar story. She beat stage 2 breast cancer in the late 1990s and enjoyed prime health afterward. But in 2009, a routine cardiac ultrasound showed her heart was pumping at only 35%. Her doctor assumed she had a blockage and scheduled emergency surgery. Instead, she called her oncologist who told her not to go under the knife: her heart problems were related to her past cancer treatment—and they could probably restore her heart function without surgery. “I have a dear friend who ended up with a pacemaker,” says Cirilo. “She had the same chemo I did. That very well could’ve happened to me had I gone [ahead with surgery].”

Sander’s and Cirilo’s stories are sadly not uncommon, and a growing field of cardio-oncology is trying to address the growing number of women who experience heart failure after undergoing chemo. “We’re dealing with two devils. We need to balance heart effects with chemo potency, and still get cancer into remission,” says Dr. Gagan Sahni, who directs the new cardio-oncology clinic at Mount Sinai in New York.

Today, Kaiser Permanente researchers presented findings at the American Heart Association’s scientific sessions that show many breast cancer patients do not get treatment for their heart problems. But those that do, are likely to get proper therapy.

“You have to consider the whole patient,” says study author Dr. Jersey Chen, a researcher and cardiologist at Kaiser Permanente. “It’s a new age of collaborative medicine where no physician is treating patients on their own.”

In earlier years, if a patient was suffering from serious heart damage during cancer treatment, they would have to stop therapy to take care of their heart. Now, doctors are trying to figure out the best way to treat both simultaneously.

At the Cleveland Clinic, every cancer patient receiving chemo drugs known to cause heart problems will see a cardiologist before and during their treatment. Patients undergo advanced cardiac imaging aimed at the early detection of damage. “What I really hope for is a change in paradigm,” says Dr. Juan Carlos Plana, co-director of the cardio-oncology center.“We should employ strategies that kill cancer and do not damage the rest of the organs.” Plana’s own mother developed heart failure from her lymphoma treatment.

Both Sander and Cirilo were treated at Cleveland Clinic, and have renewed function in their hearts thanks to drugs that prevented their hearts from overworking. Cirilo says she doesn’t want the damage her treatment had on her heart to hold her back—she recently started talking jazzercise classes. “I don’t want to carry a oxygen tank,” she says. “It doesn’t go with my clothes.”

 

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