Recent research reveals how cancer treatments increase the danger of heart disease in older people, underscoring the necessity for higher monitoring.

Test: Heart problems and stroke following cancer treatment in older people. Image Source: Tom Wanniwant / Shutterstock.com

The most recent study published within the journal Cancer examines the danger of heart problems (CVD) in older individuals who have undergone cancer treatment.

Challenges Cancer Survivors Face After Treatment

Recent advances in cancer treatment have greatly improved survival rates and prolonged life expectancy for patients. Nevertheless, cancer survivors are at greater risk of future illness, including heart problems, related to cancer or its treatment, compared with the overall population.

Actually, cancer patients are twice as prone to die from CVD. Consequently, cancer patients, especially those prescribed cardiotoxic drugs, could also be closely monitored to discover and manage CVD risk aspects, change treatment strategies, screen for heart abnormalities before and through treatment, and encourage exercise. Nevertheless, these monitoring strategies will not be routinely incorporated into the health care plan for all cancer patients.

Concerning the study

Data for this study were obtained from the Aspirin in Reducing Events within the Elderly (ASPREE) study, which aimed to evaluate the effect of cancer and its treatment on a composite cardiovascular endpoint in elderly cancer patients.

The ASPREE study included 15,454 patients from Australia and America, with a median age of 74. Prostate and colon cancer occurred in 26% and 14% of study participants, respectively; breast and blood cancer occurred in 12% each, and lung and melanoma in 8% each.

Metastatic tumors were primarily from primary lung and prostate cancer, followed by colorectal, pancreatic, ovarian, or uterine cancer. Greater than 80% of the cohort received treatment, 55% of whom underwent surgery, 45% received chemotherapy, and 29% received radiotherapy.

Increased risk of heart problems

A complete of 1392 patients received a brand new diagnosis of cancer. In comparison with patients without cancer, patients with cancer were twice as prone to be diagnosed with CVD with 10.3 and 20.8 events per 1000 person-years, respectively.

The cancer cohort had higher rates of myocardial infarction (MI), hospitalization for heart failure (HHF), total stroke, and ischemic stroke. This increased risk didn’t change after adjustment for clinical CVD risk aspects.

There was a five-fold higher rate of cancer incidence in patients with metastatic cancer in comparison with those without cancer or with localized cancer. Metastatic disease is more amenable to treatment with higher doses or more cardiotoxic drugs, contributing to a better risk of heart problems along with the increased severity related to advanced cancer.

Amongst cancer types, hematologic and lung cancers were related to a five-fold and three-fold increased risk of CVD, respectively. Importantly, lung cancer patients usually tend to smoke, which complicates CVD risk. Nevertheless, this increased risk can also be related to the usually delayed detection of lung and blood cancers.

For MI and HHF, an increased risk of CVD was observed already in the primary yr. As compared, when ischemic stroke was included, the danger of developing CVD increased more rapidly than within the cancer-free cohort from the third yr.

Amongst cancer patients, men were at higher risk of CVD after the primary yr compared with women. Patients aged 75 years and older were also at increased risk of CVD, which increased over time in each cancer- and cancer-free cohorts.

Cancer chemotherapy has also been related to a two-fold increased risk of CVD. This effect could also be attributable to the cardiotoxicity of those drugs, that are typically utilized in fitter patients.

Cancer patients who underwent surgery had a lower risk of CVD. Along with being generally fit at baseline, rapid elimination of tumor-related aspects may support risk reduction. As compared, radiotherapy was related to increased rates of MI and HHF.

There was no reduction in the danger of heart problems in patients taking aspirin, because the incidence of those diseases was similar in each groups.

Conclusions

The study results confirm previous reports of a persistent increased risk of CVD in older people after a cancer diagnosis; nonetheless, this risk diminishes after five years. The best CVD risks were observed in patients with metastatic, hematologic, and lung cancers, in addition to in those that received chemotherapy.

Aspirin has not been shown to be effective in reducing the danger of heart problems, consistent with recent studies that found no helpful cardiovascular protective effect in healthy older adults taking aspirin.

The clinical implications of our findings concern the impact of heart problems on mortality. and the indisputable fact that with appropriate screening and treatment, cardiovascular risk in cancer survivors may be reduced.”