People Who Survive Cancer May Have Increased Heart Disease Risk

A new study finds people who have had cancer are at risk for certain cardiovascular diseases. SDI Productions/Getty Images

• A new study from the United Kingdom has found that people who survive cancer may have long-term increased risk of cardiovascular disease.
• To conduct the new study, researchers from multiple institutes evaluated the medical records of 18,714 people with a previous diagnosis of cancer.
• During the study nearly 33% of cancer survivors developed forms of cardiovascular disease.

In 2023 alone, experts predict that more than 1.9 million new cases of cancer will be diagnosed in the United States. Advancements in treatment have increased survival rates for many types of cancer, but the disease can still have lasting effects on survivors.

A new study from the United Kingdom (UK) has found that people who survive cancer may have long-term increased risk of cardiovascular disease.

“We demonstrate that past cancer confers an increased risk of cardiovascular events, independent of traditional vascular risk factors,” the authors of the new study state in a press release. “This risk may extend several years beyond the initial cancer diagnosis.”

Evaluating data from the UK Biobank

To conduct the new study, researchers from multiple institutes evaluated the medical records of 18,714 people with a previous diagnosis of cancer — including breast, lung, prostate, colorectal, uterine, or blood cancers.

They also evaluated the records of an equal number of people without a history of cancer, drawing all participant records from the UK Biobank — a database that contains genetic and health information from 500,000 people across the UK between the ages of 40–69 years.

The researchers used this data to track documented changes in participants’ cardiovascular health over an average follow-up of nearly 12 years.

Overall, nearly a third of cancer survivors developed atrial fibrillation, ischemic heart disease, heart failure, stroke, or other forms of cardiovascular disease over the study period. The increase in risk was particularly high for those with a previous diagnosis of blood or breast cancer.

Roughly 19% of all cancer survivors died during the study period, compared with 8.5% of those without a history of cancer. Cardiovascular disease was the primary cause of death in more than 8% of cancer survivors who died.

“Due to the amazing progress made in cancer treatments, cancer patients are overall living longer,” Dr. Eric H. Yang, director of the UCLA Cardio-Oncology Program at the University of California, Los Angeles, told Healthline.

“[These findings] emphasize the importance of not throwing one’s heart healthcare to the wind in many cancer disease states, as it could have negative long-term consequences for one’s longevity and quality of life,” he said.

Cardiovascular changes without symptoms

In addition to tracking documented diagnoses of cardiovascular disease, the research team also examined MRI scan results for a subset of participants. This allowed them to identify changes in heart size and function, even when cardiovascular symptoms had not yet developed.

They found that heart size and function were negatively altered for cancer survivors, particularly those with a history of blood or breast cancer.

“More studies are needed to look at the unique nature of each type of cancer, their treatments, and the patients who suffer from these cancers in order to find strategies to best protect their heart health in the long term,” said Dr. Eric Yang.

More research is also needed to learn about the link between cancer and cardiovascular risk in ethnic and racial minority groups, since most of the UK Biobank participants were white.

Building on past research

The new UK study adds to a growing body of research that links cancer with increased cardiovascular risk.

“The findings of this investigation are consistent with other observations linking cancer and cardiovascular disease,” Dr. Robert Copeland-Halperin, director of Cardio-Oncology at Northwell Health in New Hyde Park, New York, told Healthline.

For example, a study published in 2019 used data from the Surveillance, Epidemiology, and End Results (SEER) program in the United States to compare deaths from cardiovascular disease among cancer survivors versus the general population.

“Patients with cancers of multiple different sites had higher heart disease mortality,” said Copeland-Halperin. “This risk was highest in the first year after diagnosis, rising again approximately 60 months after the diagnosis.”

The SEER study found that the risk of death from cardiovascular disease was highest among those with a diagnosis of endometrial cancer, which is a type of uterine cancer.

Multiple factors may increase risk

More research is needed to understand why cancer is associated with increased cardiovascular risk, but experts believe that multiple factors likely play a role.

Heart disease and cancer share some risk factors in common. For example, smoking, high blood pressure, and excess weight increase the risk of both heart disease and many forms of cancer.

These traditional risk factors were common among UK Biobank participants who had received a previous diagnosis of cancer. But even when the researchers controlled for these traditional risk factors, they found that survivors of cancer were still more likely than average to develop heart disease.

Biological processes related to some types of cancer may have negative cardiovascular effects.

Certain cancer treatments also have negative side effects that may affect cardiovascular health.

“Several cancer treatments, including chemotherapies and targeted therapies, can have cardiotoxic effects,” Dr. Jeffrey Yang, a thoracic surgeon at the Mass General Cancer Center at Massachusetts General Hospital in Boston, told Healthline.

“In addition, previous radiation to the chest — for example, for breast cancer, lung cancer, or lymphoma — can expose the heart to radiation, which may increase the risk of cardiovascular diseases during subsequent years,” he said.

Dr. Jeffrey Yang also noted that many people who are undergoing cancer treatment face financial challenges, due to the high cost of treatment or their inability to continue working during or after cancer treatment.

Financial stress may limit their ability to access high-quality healthcare, including cardiovascular care.

You can manage heart health risks

According to the experts who spoke with Healthline, the results of the UK study highlight the importance of managing risk factors for heart disease among cancer patients and survivors.

“I think that maintaining good overall health after a cancer diagnosis and treatment should be a key component of recovery from cancer treatment,” said Dr. Jeffrey Yang.

“Oncology and surgical oncology practices should ensure that patients have the resources and support to maintain a healthy lifestyle after cancer treatment. Optimizing nutrition, activity, mental health, and quality of life after cancer treatment should be a primary focus for both cancer survivors and their healthcare team,” he said.

Dr. Eric Yang noted that cancer patients who have known cardiovascular disease or significant risk factors for developing it may benefit from cardio-oncology care. This is a growing field of healthcare, led by cardiologists who specialize in cardiovascular care for cancer patients.

Copeland-Halperin encourages cancer patients and survivors to address traditional risk factors for cardiovascular disease, such as high blood pressure, high cholesterol, and diabetes. “It’s easy to neglect these at the time of a life-changing cancer diagnosis, but addressing these risk factors may improve overall outcomes,” he said.

People Who Survive Cancer May Have Increased Heart Disease Risk
Source: Pinoy Lang Sakalam

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