Early cancer therapy and heart problems

From Chicago, at a meeting of the American Society of Clinical Oncology

Numerous studies have indicated that children who receive certain chemotherapy drugs and chest-radiation treatments for cancer face a heightened risk of heart disease later in life. In a new study, researchers report that cardiovascular symptoms show up as early as 10 years after treatment.

Steven Lipshultz of the University of Rochester in New York and his colleagues documented the risk by examining 176 young-adult cancer survivors and 64 of their siblings who never had cancer. The former patients had been treated for leukemia, lymphoma, or another cancer an average of 15 years before the study.

Compared with their siblings, the cancer survivors had more signs of atherosclerosis, the accumulation of fatty plaques in arteries that underpins heart disease. The former patients also had significantly greater weakening of the heart muscle, a higher pulse rate, and higher blood concentrations of a compound called homocysteine that’s linked with heart disease. They also were less physically active.

These differences were present even though most people in both groups were outwardly healthy and less than 21 years old–an age when doctors would expect to see few signs of heart disease, Lipshultz says. The indicators suggest the cancer survivors had heart damage and were working harder to maintain circulation, Lipshultz says.

The treatments received by the cancer patients included radiation to the chest and chemotherapy with drugs called anthracyclines. Previous research indicated that such treatments cause chronic inflammation that can damage heart cells, notes Melissa Hudson of St. Jude Children’s Research Hospital in Memphis, Tenn.

Hudson says doctors today are better shielding children’s hearts from radiation and giving them lower doses of anthracyclines than when the children in Lipshultz’ study received treatment.

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