What Is Cardiotoxicity?

Cancer care and heart disease are linked

If you have cancer, your doctors are primarily focused on treatment — shrinking tumors, stopping the progression and ultimately reaching cancer remission. But during treatment, it’s still important to pay close attention to the rest of your health.

Cancer treatments are powerful and designed to kill cancer cells, but they also can harm healthy cells and tissues — even those in the heart — that can lead to side effects and other health problems.

“Chemotherapy and other cancer treatments are life-saving therapies that are improving outcomes and helping people live longer,” says Eileen Rattigan, MD, a cardiologist at Geisinger. “But just because you’re being treated for cancer doesn’t mean the rest of your health goes on hold. There are many side effects to cancer treatment that can put you at risk for other health problems, including heart disease, or cardiotoxicity.”

What is cardiotoxicity?

Cardiotoxicity is when cancer treatments like chemotherapy or radiation unintentionally damage the heart muscle or its blood vessels. It can develop during cancer treatment or many years later.

Cardiotoxicity disrupts the heart’s normal functions. Left untreated, cardiotoxicity can lead to heart failure, myocarditis (inflammation in the heart muscle), premature coronary artery disease and arrhythmias.

“Not all cancer treatments have the potential to harm the heart,” says Dr. Rattigan. “However, certain types of cancer treatments and a person’s individual risk factors at the time of the cancer diagnosis, such as a pre-exiting heart condition, poor lifestyle or genetic factors, can increase the risk of cardiotoxicity.”

Cardiotoxicity symptoms

Common cardiotoxicity symptoms can include:

Shortness of breath
Chest pain or discomfort
Heart palpitations or irregular heartbeat
Fatigue and weakness
Dizziness or lightheadedness
Swelling in the legs and feet

“The best thing you can do is talk to your oncologist about all symptoms you’re having during cancer treatment and your individual risk factors for heart disease,” says Dr. Rattigan. “Recognizing cardiotoxicity symptoms early is essential for timely intervention to reduce long-term effects.”

How cancer treatment can cause cardiotoxicity

Radiation and chemotherapy are some of the most common ways to treat cancer. While they’re essential for shrinking or removing tumors, these cancer treatments can pose risks to your heart, too.

Some types of chemotherapy and targeted therapy drugs can cause cardiotoxicity or damage to your heart, especially if you receive a high dose or a combination of drugs. Your oncologist will weigh your cancer and heart disease risk when choosing medications and dosages.

In addition, radiation can negatively affect the heart, especially when targeting the chest to treat breast or lung cancer. To help reduce the risk of heart damage, new positions and techniques are being used during radiation treatment.

4 strategies to protect the heart during cancer treatment

If you’re at a higher risk for or already have heart disease, talk with your oncologist about ways to protect your ticker during cancer treatment.

Cardio-oncology is a new cardiology specialty that focuses on the cardiovascular care of cancer patients and survivors. These providers work diligently to manage cardiovascular risks without disrupting treatment.

To reduce the risk of cardiotoxicity, cardio-oncology specialists are using these 4 strategies to help protect the heart during cancer treatment:

Regular cardiovascular monitoring

Monitoring your heart during and after cancer treatment is essential to detect any signs of cardiotoxicity early. Your provider may perform echocardiograms, measure cardiac biomarkers and monitor your symptoms to assess your heart function and identify any changes that may require intervention.

Medication management

Your oncologist and cardio-oncologist will work together to carefully select cancer drugs and doses to maximize your chances for a cancer cure while minimizing your risk for cardiotoxicity.

Heart-protective medications

Your cardio-oncologist also may prescribe medications specifically designed to protect your heart. These drugs can help your heart work more efficiently while mitigating the potential damage caused by certain cancer drugs.

Lifestyle modifications

Follow a heart-healthy lifestyle during and after cancer treatment. This includes maintaining a healthy weight, eating a balanced diet rich in fruits, vegetables and whole grains, and getting regular physical activity. Also, avoid tobacco use and limit alcohol consumption to support your heart health.

“Prevention is the best protection for your heart,” says Dr. Rattigan. “Before starting cancer treatment, have a heart-to-heart with your oncologist about the benefits and risks of your treatment plan. Together, you can take steps to protect your heart throughout your cancer journey and beyond.”