Thirteen years ago, Kim Sander received her first breast cancer diagnosis. A decade later, she found out the cancer medication she was put on in 2008 was causing heart problems.
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“Patients’ hearts should be monitored by a cardiologist throughout their cancer treatment.”
“I knew that the medication I was on could affect the heart, but I was told my lab work was good,” says Kim. “So when I came to Cleveland Clinic, I was surprised to learn that I did have heart muscle damage and so grateful that my doctor here recognized the problem.”
Today, Kim’s heart muscle is strong again thanks to the Cardio-Oncology Center at Cleveland Clinic. And her breast cancer is in remission.
“Research is showing that some of the most effective treatments for cancer—especially treatments for certain types of breast cancer—can lead to heart disease,” explains Juan Carlos Plana, MD, co-director of Cleveland Clinic’s Cardio-Oncology Center. “We are here to monitor and address any and all heart issues that might arise for cancer patients before, during or after their course of treatment.”
Monitoring for heart issues
Today, physicians look at a cancer patient’s ejection fraction (EF) percentage to monitor for heart issues. The EF is the force at which the heart muscle pushes blood from the left ventricle.
As standard procedure, anything at a 50 percent or above EF is considered safe. While Kim was in this safe range with an EF of 51, she was beginning to have flushing symptoms and her blood pressure was up. And her EF had gone down from 62 percent from just a couple years earlier.
When Dr. Plana saw these readings, he ordered a new, more sensitive kind of cardiac imaging for Kim called strain echocardiography. From this, he clearly saw that her heart muscle had been weakened. He immediately prescribed an ace inhibitor and beta blocker to reverse the damage. Within a few months, Kim’s EF went up and her heart was on the mend.
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Today, Kim continues to take the heart meds, and with her cancer in remission, she has been off treatment for more than a year. “It is such a relief,” she says. “And now I want to help get the word out to other cancer patients that they need to talk to their doctors and pay close attention to their hearts.”
Why Cleveland Clinic?
Kim, now 53, is from Pemberville, Ohio (near Toledo). She came to Cleveland Clinic in 2010 seeking a higher level of care after she had her third recurrence of breast cancer. She took part in a drug trial that included Herceptin® in combination with other drugs. As part of the drug trial, heart monitoring was required and she was soon referred to Dr. Plana and the Cardio-Oncology Center. “I learned that not all doctors know when to take a closer look at the symptoms, and I am so thankful that Dr. Plana did,” she says.
Dr. Plana’s Advice
Dr. Plana advises that even before beginning a cancer treatment regimen, patients should talk to their doctors about the possible cardiovascular side effects. And he says, “Patients’ hearts should be monitored by a cardiologist throughout their cancer treatment.”