A recent scientific statement from the American Heart Association warned that many breast cancer treatments can cause heart disease and heart failure. The news release understandably triggered many questions and concerns for breast cancer survivors.
With improving cure rates, a reduction in long term effects and improved long term survivorship is the goal when treating women with curable breast cancer. Both specific chemotherapy drugs and radiation therapy do carry some cardiac risk, but there are steps that can be taken to lower the risk of heart damage in breast cancer patients receiving radiation.
Today’s radiation is much different from the radiation therapy patients received in the past. Thanks to technological advances, radiation is more targeted and doses to surrounding normal structures are now lower. Advances in treatment planning, equipment, and improved techniques for delivery of radiation make it possible to track heartbeats and lung movement to better protect organs from unnecessary radiation reduce the risk of heart disease.
Positioning changes, such as having the patient lie on her stomach during treatments, as well as the use of targeted delivery, makes it is possible to limit the amount of radiation that unintentionally travels to the heart and thus reduce the risk of heart disease in the future.
Proton therapy is one way we are able to protect the heart and other vital organs. Protons are physically different from traditional radiation and can precisely target the tumor site with virtually no radiation going to the heart. There is also a significant reduction in the amount of radiation that reaches the lungs with proton therapy.
As part of a research team that analyzed trends in cardiac biomarkers following adjuvant proton therapy for breast cancer, my team monitored troponin T (a protein released into the blood when the heart sustains damage) and proBNT (a hormone produced by the heart and released in response to pressure changes within the heart) levels and found there were no changes to indicate injury to the heart with proton therapy.
While women preparing for breast cancer treatment should be aware of the risk between such radiation therapy and heart disease, they should not be deterred from receiving radiation. Early stage breast cancer treated with lumpectomy and radiation has proven to be as effective as mastectomy. Studies have also shown cancer recurrence was reduced in women with early-stage breast cancer in one to three lymph nodes who received radiation following mastectomy. Dr. Ackerman was recently on Jacksonville’s Channel 4 News discussing the risk of heart disease for breast cancer patients, and how proton therapy reduces that risk. You can watch his segment here.
I advise women to have their heart health evaluated and make their doctors aware of any heart disease risk factors they may have before starting breast cancer treatment. Through treatment and beyond, maintaining a heart-healthy lifestyle that includes regular exercise and a healthful eating plan is good for your heart and your health. If you have questions about breast cancer treatment and heart disease risk, please e-mail me at firstname.lastname@example.org.