Cancer treatment can be toxic to the heart
Updated On: Apr 13 2014 12:00:00 AM EDT
Fit and strong are two words to describe Derek Fitzgerald, but his life is just getting back on track after doctors found a grapefruit-sized tumor in his stomach ten years ago and diagnosed him with non-Hodgkin’s lymphoma.
“They said, 'Derek, you’ve got cancer,'” Fitzgerald recalled.
His best shot at survival was chemotherapy. Fitzgerald underwent six rounds. It destroyed the cancer, but also damaged his heart.
Fitzgerald lived with severe heart failure for seven years. Then he was placed on the transplant list.
“Every night as I closed my eyes to go to sleep, I wondered, how long can I go through this? How much more can my body take before I just close my eyes and don’t wake up?” Fitzgerald said.
It’s a reality doctors say few patients are aware of.
“In Derek’s case, there are chemotherapy agents that actually weaken the heart,” explained Dr. Mariell Jessup, Professor of Medicine, University of Pennsylvania, Penn Medicine Heart & Vascular Center.
“So many patients that come here say, ‘I just can’t believe something else happened to me,’” she said.
Jessup recommends talking to your doctor about your risk and getting regular health screenings.
Fitzgerald found a new heart and despite having never exercised before, began to, to honor his donor. Eight months post-transplant, he ran his first 5K. Two months later he ran a half-marathon. Just two years later—he completed his first Ironman.
“Every time I get out there, it’s a celebration of this chance that I’ve been given,” Fitzgerald explained.
Fitzgerald is the first cancer and heart transplant survivor to finish an Ironman and his third chance at life keeps getting better. After struggling with infertility, he and his wife had their first baby this year.
Cancer cells grow and divide more rapidly than normal cells, so many anticancer drugs are made to kill growing cells. However, certain normal healthy cells multiply quickly, and chemotherapy can affect these cells also. Damage to normal cells can cause side effects. The fast-growing, normal cells most likely to be affected are blood cells forming in the bone marrow and cells in the digestive tract (stomach, mouth, intestines), reproductive system (sexual organs), and hair follicles. Some anticancer drugs may affect cells of vital organs, like kidney, bladder, lungs, nervous system, and the heart. (Source:medicinenet.com)
CANCER TREATMENT AND HEART DISEASE: Chemotherapy side effects may increase the risk of heart disease, including weakening of the heart muscle and rhythm disturbances (arrhythmias). Some chemotherapy agents with cardiovascular effects include:
- arsenic trioxide (Trisenox)—Q-T prolongation
- bevacizumab (Avastin)—Severe hypertension, heart failure, cardiomyopathy, thromboembolism
- cisplatin (Platinol)—Severe hypertension, ischemia, atrial fibrillation, thromboembolism
- doxorubicin (Adriamycin) and other anthracyclines—Cardiomyopathy, heart failure, cardiac shock
- fluorouracil 5-FU (Adrucil)—Ischemia
- Interleukin-2—Atrial fibrillation
- mitomycin (Mutamycin)—Heart failure
- mitoxantrone—Heart failure
- pazopanib (Votrient)—Severe hypertension
- sorafenib—Severe hypertension, heart failure, thromboembolism
- trastuzumab (Herceptin)—Heart failure
PREVENTION: If your doctor suggests using a chemotherapy drug that may affect your heart, you may choose to undergo heart function testing before starting treatment. During treatment, you may need periodic heart monitoring. If you have a pre-existing heart condition, like cardiomyopathy, your doctor may suggest a different type of chemotherapy. Some cancers require radiation. If the area of your body receiving radiation includes your heart, you have an increased risk of cardiomyopathy, heart attack, and coronary artery disease. The combination of chemotherapy and radiation can further increase your risk of heart damage. (Source:mayoclinic.org)
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