Interrelation between Heart Failure and Cancer may need Multidisciplinary Approach, suggests study
A recent scientific statement from the Heart Failure Society of America discussed the various risk factors, mechanisms, diagnosis, and management strategies and also the relationship between heart failure and cancer. The article was published in the Journal of Cardiac Failure.
Heart failure and cancer have a complex link with shared biological processes of inflammation, cell death, mutations, and hormonal alterations. One condition can lead to the risk of developing into another. Specific genetic markers like clonal hematopoiesis increase the risk of cardiac disease and cancer. Mutations of these markers have similar poor outcomes in both cancers and cardiac diseases.
Hypertension, Diabetes, obesity, and habits like smoking increase the risk of heart failure and cancer when under-addressed leading to complicated course. Literature in the past has shown that hypertension can increase the risk of cancer and diabetes that is linked to inflammation and oxidative stress can lead to cardiac pathologies and cancers.
Heart failure can also occur as a treatment side effect in cancers. Chemotherapeutic drugs like anthracyclines, HER-2 targeted therapies and radiotherapies can cause heart failure in cancer patients. Alkylating agents like cyclophosphamide can cause acute heart damage, antimetabolites like 5-fluorouracil can cause temporary heart conditions, and tyrosine kinase inhibitors also can cause cardiac complications. However, early detection and intervention can help in managing certain cardiac conditions.
Individuals at high risk of cardiac morbidities from cancer therapies have to be evaluated by regular echocardiograms, blood markers, and troponins to track their cardiac health. Individuals who show early signs of cardiac malfunction can continue the cancer therapies with cardio-protective medications. In the case of advanced cardiac diseases while receiving cancer therapies a multidisciplinary approach is needed to balance both cardiac and cancer diseases.
They have also mentioned that in individuals who are undergoing advanced therapies like stem cell transplants and immunotherapies myocarditis can occur. In such cases, heart imaging and genetic profiling should be done to reduce the risk.
Researchers also emphasized a multidisciplinary approach with cardiologists, oncologists, palliative care, pharmacy, and nursing teams in monitoring, identifying, and preventing cardiac complications. Preventive strategies using a multidisciplinary approach can improve the quality of life and reduce the burden of heart failure in long-term outcomes for cancer patients.
Further reading: Cardio-Oncology and Heart Failure: A Scientific Statement from the Heart Failure Society of America. Doi: 10.1016/j.cardfail.2024.08.04
