The connection between cancer and cardiovascular disease is becoming increasingly clear, with both conditions sharing risk factors and, crucially, influencing each other’s development. This growing understanding has fueled the emergence of cardio-oncology, a specialized field dedicated to addressing the unique cardiovascular challenges faced by cancer patients. Experts warn that these two leading causes of death in the Western world are often intertwined, demanding a more integrated approach to patient care.
During a virtual meeting with health journalists in Latin America, cardiologist Joerg Herrmann, founder and director of the Cardio-Oncology Clinic at Mayo Clinic in Minnesota, emphasized the bidirectional relationship between heart disease and cancer. “In the Western world, including Latin America, heart disease and cancer are neighbors, leaders, and what we’ve realized in the last decade is that they often go together,” Herrmann stated. This convergence isn’t simply a matter of shared risk factors like smoking, obesity, and a sedentary lifestyle; the diseases can actively exacerbate one another.
Herrmann detailed how established risk factors contribute to both illnesses. For example, smoking is not only a primary cause of lung cancer but similarly significantly increases the risk of cardiovascular diseases such as atherosclerosis and stroke. Obesity and chronic inflammation also play a critical role in elevating the risk of both pathologies, according to Herrmann. He highlighted that adopting healthy habits – including regular physical activity – can substantially reduce the incidence of these diseases and improve overall life expectancy.
Joerg Herrmann, cardiologist. (SOURCE EXTERNA)
The Bidirectional Relationship: A Two-Way Street
The relationship between cancer and heart disease isn’t one-sided. Herrmann explained that patients with cancer have a heightened risk of developing cardiac problems, while individuals with pre-existing cardiovascular conditions are also more susceptible to cancer. “Cardiac disease, heart failure for example, insufficient cardiac function is associated, should say, with a greater risk of developing cancer. That is to say, this is a two-way street,” he clarified. This interaction extends beyond traditional risk factors, with both diseases “communicating” through biological mechanisms like inflammation and oxidative stress.
Cardio-Oncology: A Growing Field
Recognizing this complex interplay, cardio-oncology has emerged over the past two decades as a specialized field focused on mitigating the cardiovascular effects of cancer treatments. While sometimes referred to as oncocardiology, Herrmann prefers the term cardio-oncology. He noted that the field has made significant strides in reducing the cardiovascular burden on oncology patients through various measures. These include modifying cancer treatments to lessen their impact on the heart, utilizing medications to counteract adverse effects, and refining radiotherapy techniques. In some cases, strategies are employed to protect organs during treatment, such as positioning patients during breast cancer radiation to minimize heart exposure.
Individualized Treatment Priorities
When a patient presents with both cancer and cardiovascular disease simultaneously, treatment decisions must be tailored to the individual case, Herrmann emphasized. “What priority? What comes first? Unfortunately, it’s not common to have such severe diseases at the same time,” he said. As an example, he described a scenario where a patient with lymphoma also has severe aortic stenosis; in such cases, the cardiac condition would be addressed first to enable subsequent chemotherapy.
Risks Associated with Cancer Treatment
Herrmann also acknowledged the potential for cancer treatments themselves to negatively impact the heart, sometimes severely. “Yes, it’s true… patients die, they die from a complication, not from the cancer,” he cautioned, referencing cases of myocarditis linked to certain treatments. However, he clarified that these complications are not frequent, although they can be serious in specific instances.
The Role of Artificial Intelligence and Prevention
Looking ahead, Herrmann highlighted the growing role of artificial intelligence (AI) in the early detection of cardiovascular risks in cancer patients. “We are working particularly intensely on how to use new technologies, how to use artificial intelligence to identify patients at risk of adverse events from oncological therapy, even before that therapy begins,” he stated. These tools can analyze data like electrocardiograms to anticipate complications and optimize clinical follow-up.
Herrmann stressed the importance of prevention, controlling risk factors, and fostering collaboration between physicians of different specialties. “If there’s one word here that needs to be repeated, it’s collaboration between oncologists, hematologists, and cardiologists – that’s key, and the focus must be on the patient,” he concluded. He also urged maintaining hope in the face of a cancer diagnosis, pointing to the advancements made in treatments and the reduction in mortality rates in recent decades.
As research continues to unravel the complex relationship between cancer and cardiovascular disease, a more holistic and integrated approach to patient care will be essential. The continued development of cardio-oncology, coupled with advancements in AI and a renewed focus on preventative measures, offers promising avenues for improving outcomes for individuals facing these challenging conditions.
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Disclaimer: This information is intended for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
