Protecting your heart health during breast cancer treatment

For someone diagnosed with breast cancer, there is much to take in – treatment options, possible side effects and what lies ahead.

Amid these worries, cardiovascular health can be easily overlooked, yet it remains an important part of a patient’s care.

This Pinktober, Dr Rowina Lynne Murray, a clinical cardiologist at Institut Jantung Negara (IJN), sheds light on how breast cancer treatment can affect the heart and why early detection may reduce the need for more aggressive treatment.

According to Murray, breast cancer and cardiovascular disease share the same risk factors such as obesity, smoking and an unhealthy diet.

Some hormone treatments, she added, may increase blood pressure or raise cholesterol levels, while certain chemotherapy drugs can weaken the heart muscle and lead to heart failure.

Radiotherapy to the chest can also damage the heart or cause its blood vessels to narrow. Such damage from cancer treatment is known as cardiotoxicity.

“Cancer-related heart disease occurs in about 5-15% of women treated for breast cancer, so it’s quite common,” said Murray, 41.

Older women, especially those aged 60 and above, as well as those with high blood pressure or diabetes, may be more vulnerable to heart complications.

The risk can further increase with more intensive or prolonged breast cancer treatment, including among younger patients with no history of heart problems.

It is therefore worth discussing your cardiovascular health with your doctor before starting breast cancer treatment. They may recommend blood tests, an electrocardiogram (ECG) to detect abnormalities and an echocardiogram (echo) to assess how well your heart is pumping.

Heart health also deserves attention once treatment begins, so keep an eye out for symptoms such as breathlessness, swollen legs, chest pain or palpitations. Doctors may repeat a heart echo every three months, or earlier if necessary.

A measurement taken during the scan, known as global longitudinal strain, can help detect early weakening of the heart.

If a heart problem develops, it does not necessarily mean cancer treatment has to stop. Doctors will evaluate whether the condition can be treated and work with cancer specialists to weigh the risks and benefits of continuing treatment.

“If we can catch the heart problem early enough, or if we can identify patients at risk, there are certain medications that can stop or slow down the progression of the disease. Of course, it would depend on the individual’s response, but there are things we can do to slow down the progressions,” said Murray.

Caring for your heart during breast cancer treatment can begin with everyday habits: quitting smoking, limiting or avoiding alcohol, eating a balanced diet and keeping up with recommended health screenings.

Keep moving, too – moderate-intensity activities, such as brisk walking, can also support heart health.

“Remember that the focus is still to cure your breast cancer. You shouldn’t refuse treatment because you are scared of developing a heart problem. All of this has to be discussed with your doctors.

“Don’t refuse treatment just because you’re worried about something that has not happened yet. There are things we can do to make these treatments safe for you. Always consult your doctor before you make a decision,” Murray advised.

Early detection, she added, allows breast cancer to be treated at a lower stage, when treatments tend to be less aggressive. “We would therefore expect a lower risk for treatment-related toxicities as well.”

This Pinktober, give your health the attention it deserves by asking IJN about its breast cancer screening services.

If cost is a concern, reach out to the National Population and Family Development Board (LPPKN) or cancer-related NGOs to find out about free or subsidised screening.

The first step is a conversation. Make it yours today.

Visit IJN’s website for more information. Learn more about IJN on Facebook, Instagram and YouTube.

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