First, Do No Harm to the Heart

Many cancer treatments may cause heart disease

stethoscope on heart

Many cancer treatments may cause heart disease. Case in point: trastuzumab (Herceptin). A recent study led by Lorenzo Moja, MD, of the University of Milan in Italy, shows that trastuzumab prolongs overall survival and cancer-free survival in both early and late-stage breast cancer patients. That same study also showed that trastuzumab elevates the risk of congestive heart failure. Significantly.

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One cardiologist who read this study with particular interest was Juan Carlos Plana, MD  from Cleveland Clinic. Dr. Plana is co-director of Cleveland Clinic’s new Cardio-Oncology Center. He and his colleagues are focused on minimizing or preventing precisely the side-effects noted by the Milan team.

“There are 2.2 million survivors of breast cancer in the U.S.alone,” says Dr. Plana, “and once one survives cancer treatment, heart disease is the biggest risk they face.”

The study indicates that patients using trastuzumab have a five-fold increase in the risk for congestive heart failure.

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“The goal is not to stop cancer therapy, but to identify cardiotoxicity early and to protect the heart with medications so heart failure does not become a problem and the cancer treatment can be continued,” says Dr. Plana.

Using advanced echocardiography  with 3D, contrast and strain imaging ,  Dr. Plana and his colleagues monitor patients who are undergoing cancer treatment, and address heart issues as they arise.

“We can see from this new study that regimens containing trastuzumab were associated with greater overall and cancer free survival,” says Dr. Plana. “However this benefit in survival comes at the expense of a 5 fold increase in risk of developing congestive heart failure. Fortunately, we now have the ability to identify and treat damage to cardiac tissue early, and prevent it from progressing to  heart failure .”