Quick guide to managing heart health after cancer treatment

Educational Updates and Workshops:

Prof Mike Kirby in association with Macmillan

Improvements in cancer treatment and earlier diagnosis have contributed to increased survival. Unfortunately, many cancer treatments carry an increased risk of promoting cardiovascular disease (CVD).The CVD risk is of particular consideration in an ageing population of cancer survivors who may have co-morbidities which also exacerbate this risk, and in adult survivors of childhood cancer treatment who may present with CVD symptoms at a relatively young age. Heart disease following cancer treatment may be the result of direct CV damage caused by the treatment or may be due to the promotion of cancer treatment-related CV risk factors. Working with other professionals when necessary, general practitioners (GPs) and primary care nurses are in a good position to follow-up people affected by cancer to ensure that CV risks are monitored, CVD diagnosed and appropriate treatments initiated.

  • Surveillance depends upon which cardiotoxic cancer treatments were received, e.g. anthracycline chemotherapy, radiotherapy involving the heart, and androgen deprivation hormonal therapies
  • Those with the risk factors, even if asymptomatic, should be regularly (at least once a year) screened for co-morbidities (i.e. hypertension, diabetes, dyslipidaemia, overweight/obesity) and should be counselled against smoking and physical inactivity (as appropriate) and on the benefits of an overall healthy lifestyle
  • Surveillance of people who have had cardiotoxic cancer treatment should begin within 2 years of completion of cancer therapy and continue every 5 years thereafter
  • Heart failure surveillance should be considered in at-risk groups (5 year ECHO and/or BNP measurements)

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