Protecting Your Heart During Cancer Treatment

By Keith I. Block, MD

People who have survived cancer with the help of conventional treatments should be aware of any potential long-term toxic effects of those treatments.  Among the more common problems in this regard is cardiotoxicity, which refers to damage to the heart and cardiovascular system.  Given that heart disease is the leading cause of death in the United States for both men and women, it stands to reason that many cancer patients are already at risk of developing cardiovascular disease, and thus any further stress to the heart merits serious attention.  According to the CDC, almost 700,000 people in our country die of heart disease annually—about 29% of all U.S. deaths.

 

Let’s first take a look at those cancer treatments that have potentially heart-damaging effects.  Physicians have known for over 30 years that adriamycin and other anthracycline chemotherapy drugs cause heart damage in both the short and long terms.  Less widely appreciated, however, are the major cardiotoxic effects of radiation therapy, hormonal therapy (aromatase inhibitors in particular), and chemotherapy with Herceptin and taxanes (e.g., Taxol).

Cardiovascular complications related to cancer therapy are a special concern in older postmenopausal women with existing cardiovascular disease (CVD) or in those who are at high risk for developing CVD.  It is not unusual for a breast cancer patient, for example, to receive anthracycline chemo, Herceptin, and radiation therapy before then starting on hormonal therapy with aromatase inhibitors.  Following such exposures, these women are at substantial risk of developing serious heart problems down the road.

So what can a cancer survivor do to maintain a healthy heart and stave off CVD, particularly after going through so many cardiotoxic treatments?  First off, it may be helpful to determine your risk of heart damage with the help of a MUGA scan, which is often done prior to receiving certain treatments.  This test gives you a good idea of how well the heart is functioning and whether it is pumping blood properly. 

Some chemotherapy treatments can produce more obvious signs of heart problems, such as fluid buildup in your body, resulting in a condition called congestive heart failure (CHF).  People with CHF may experience shortness of breath, dizziness, swollen hands and feet, and an irregular heartbeat.  This condition tends to be more common in older cancer patients, and it can lead to a rapid downward spiral unless caught early and properly treated.

 Regardless of whether you have any suspect signs and symptoms, or whether you undergo a complete cardiovascular evaluation by a cardiologist, it may be helpful to adopt a heart-friendly diet and lifestyle if you’ve been exposed to any of the above-mentioned cardiotoxic treatments.  The LOC diet and fitness plans are an excellent place to start.  Fortunately, there is a great deal of overlap between a healthy, plant-based diet and the goals of cardiovascular health.  And of course, getting regular aerobic exercise is one of the keys to maintaining a healthy heart over the long term.

Some drugs, notably statins (commonly prescribed for high cholesterol) and certain chemo drugs, tend to deplete the body’s supply of coenzyme Q10, also called CoQ10. This coenzyme is necessary for normal energy metabolism, and those organs with the highest energy requirements—such as the heart, liver and kidney—have the highest CoQ10 concentrations.  It turns out that supplementing with CoQ10 can be an effective strategy for many cancer patients—both in terms of countering heart damage and possibly even enhancing certain cancer treatments.

For patients with low CoQ10 levels, or those at risk of deficiency, I will advise taking at least 30 mg of CoQ10 per day, and 200 mg or considerably more if they are on heart-damaging drugs.  Also, if you are someone at risk of CHF, or in the early stages of CHF, you’ll definitely want to consider taking CoQ10.

Other heart-friendly supplements include L-carnitine and magnesium.  L-carnitine, an antioxidant, has been very useful in boosting vitality following chemotherapy, and, like CoQ10, has been found to help protect against heart toxicity caused by anthracycline chemo drugs.  Magnesium deficiency is the most common nutrient deficiency in the United States, and again, certain chemo regimens—notably those that contain platinum drugs—tend to promote or exacerbate the deficiency.  In general, people with heart disease or at risk of heart disease can greatly benefit from daily magnesium supplementation, though dosages will vary depending on the degree of deficiency and individual factors.

 

 

Comments

[Laura Sutherland]

This is such good information. I've taken COQ10 for years for my hypertension. Unfortunately my oncologist insisted I go off of it during my chemotherapy, which included Adriamycin and Taxol. My radiation oncologist was happy for me to resume the COQ10 during that phase of my treatment. I do hope this info is getting out to
the doctors who treat, as well as to cancer patients!

[Caren]

Hi Keith,
Thanks for giving such valuable information. i have breast cancer and I will begin my chemo treatment next week. Can you please tell me how to prevent side effects of chemotherapy?

[clinical oncology]

People who have survived cancer with the help of conventional treatments should be aware of any potential long-term toxic effects of those treatments. Among the more common problems in this regard is cardiotoxicity, which refers to damage to the heart and cardiovascular system. Given that heart disease is the leading cause of death in the United States for both men and women, it stands to reason that many cancer patients are already at risk of developing cardiovascular disease, and thus any further stress to the heart merits serious attention.

[Raw Food Guys]

I read most of your recipes and I like them because you don't use meat. Still I think it's very important to add at least 60% of living food, to provide a good alkaline diet for a cancer patient or one recovering from it.
Still, great job!