Late effect of chemotherapy: Heart Damage

[Jo Ann]

New data suggests chemotherapy patients benefit from heart failure treatment

More than one-third of patients undergoing chemotherapy at risk for heart failure

Researchers at The University of Texas M. D. Anderson Cancer Center have found that cancer patients who develop heart failure as a result of chemotherapy treatment can be effectively treated, with the condition potentially reversed, when standard medicated therapy for heart failure is utilized.

 
click here to read full article

http://www.innovations-report.de/html/berichte/medizin_gesundheit/bericht-13143.html

or

http://tinyurl.com/asoed

[Mary]

Over half of the survivors who received anthracyclines (Adriamycin - doxorubicin; Cerubidine – daunorubicin; Idamycin – idarubicin) will have some damage to the heart muscle that can be detected with sophisticated testing.

Read more here.

[Cathy]

Arlene,

I'll be the hat trick on this one.  Go ahead and ask for a referral to a cardiologist.  They won't think you're crazy as you have had meds that CAN cause problems with the heart. 

I was having pain and just tiring so easily that I requested from my oncologist a "heart test", so he ordered an Ejection/fraction test that measures the input and output of blood from the heart as well as how the muscle of the heart is functioning - specificially because adriamyicin can damage the heart.  I'm not sure what chemo you had, but it's worth your peace of mind - it helped me relax more on the heart damage issue as everything came out fine.

Hope you feel better very soon.  Glad the meds are helping.

Cathy

[Mariana]

Yup...I've got this one too.  I have ventricular tachycardia and arrhythmia to add to my list of added bonuses!  I have to take  meds for it only til- FOREVER! Also got kidney damage that makes me lose potassium that adds to my heart arrhythmia.  But at least I'm still here,right?

[David]

Hi everyone,

Not much of surprise considering we've been injected with rather lethal chemicals; if they're strong enough to kill cancer cells and significantly affect our white blood cell count, perhaps it's not surprising they do further damage. But I guess it's the price to pay to be alive for most of us  .

Chemo was 15 years ago so I'd rather not think about it.
I'm trying to get a medical in France to renew my scuba-diving license, and they've latched onto a previous history of heart problem (murmur or leaking valve). I have further tests to undergo but they're already talking about preventive surgery and not allowing me to dive; aren't doctors optimistic 

I don't even want to think about the prospect of heart surgery, let alone not being able to dive, it's one of the few passions I have in life. Other than tennis / badminton even though it's not exactly recommended.

On another note I've had the nasty surprise of being targetted by insurance companies when applying for a mortgage, they seem to take pleasure into adding a huge premium (double the rate) due to my "history". For another loan, they refused to insure me (lol). Not sure if you're better off in the US.

Hope to keep going for another few years. Let's hope long-term effects are not that bad. I sometimes wonder whether psychological effects are not worse? 

Merry Xmas and Happy New Year to you all.
For those of you facing surgery or undergoing treatment I wish you all the best during these difficult times..

David

[Charlene]

YIPPY!  count me in on this one too.    i've been diagnosed with an arrhythmia and also septal wall motion  (enlargementof heart wall).  thankfully my condition does not require meds which i am hoping to avoid for as long as i can. 

once again, according to the long term follow-up guidelines an ECHO or MUGA scan are recommended every yr, 2 yrs or 5 yrs depending on dose and if occurred with or without radiation.  it's important even if do not have signs and symoms to get proper follow-up care as some of the effects can occur years after completion of treatment.  and just as important with any symptoms to have them checked out as lung blood clot can mimic some heart problems.  i speak from expereince as this happened to me. 

long-term survivorship guidelines:
http://www.childrensoncologygroup.org/disc/LE/default.htm

[Mary]

Anti-cancer drugs such as anthracylines are known to damage the heart - but Dutch researchers have shown that damage gets worse over the years.

They followed up 22 children and young adults treated with the drug doxorubicin for bone tumours.

The University of Groningen researchers say people who take the drugs should be given life-long cardiac monitoring. The study appears in Annals of Oncology.

Read more here.

[Garret]

Reading that makes me determined to bring this up at my next check up in September.

I had plenty of that truly awful Adriamycin stuff pumped into me in 1991-1992 and honestly, I've never felt as sick in my life as that stuff made me.  Hey, I know it did the trick at the time, but somehow I'm not surprised that such a lethal and potent chemical may induce heart problems further down the line.

I guess its better to be safe than sorry on this so I'll definitely have to ask the good folks at St Vincents Hospital in Dublin about it.

[David]

Hi,

There's a parallel thread in the "private" area but I think links related to adriamycin (doxorubicin) would be useful here.

Here are a few I foud, moderators are free to reorganise / add / etc. as they wish, I think perhaps similar info is available somewhere on the website. Give the enlargement of my aortic valve will force me to have a replacement, I want to know any effects of chemo, particularly in the future. Cardiologists seem unaware of effects of chemo, so I would rather trust the info I find rather than rely on them :-)

Very detailed 2004 article "Anthracyclines: Molecular Advances and Pharmacologic Developments in Antitumor Activity and Cardiotoxicity" (full text pdf link on page) http://pharmrev.aspetjournals.org/cgi/content/abstract/56/2/185 (see articles that refer to it too)

MUGA scan used to evaluate  heart *before* and after chemo: http://heartdisease.about.com/cs/otherriskfactors/l/blmuga.htm
Medical info on Doxurobicin: http://www.mayoclinic.com/health/drug-information/DR202209
Effects of chemo on the heart: http://www.acor.org/ped-onc/survivors/cardio.html
Doxurobicin and heart problems: http://lymphoma.about.com/od/livingwithlymphoma/p/cardiotoxicity.htm
National Cancer Institute heart risk report (2003): http://www.cancer.gov/clinicaltrials/results/congestive-heart-failure0503
1993 Research article "Doxorubicin (Adriamycin) Cardiomyopathy—A Critical Review" with full text pdf (free): http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1021516
1996 research "Anthracycline-Induced Cardiotoxicity" http://www.annals.org/cgi/content/full/125/1/47
1997 research article "Adriamycin cardiomyopathy: pathophysiology and prevention" (full text pdf link on page)http://www.fasebj.org/cgi/content/abstract/11/12/931 (see articles that refer to it too)
2003 research article "Ongoing Care of Patients After Primary Treatment for Their Cancer" current as of Aug 2007 (free pdf) http://caonline.amcancersoc.org/cgi/content/abstract/53/3/172
2004 research article "Subclinical Late Cardiomyopathy After Doxorubicin Therapy for Lymphoma in adults" http://jco.ascopubs.org/cgi/reprint/22/10/1864
2006 research article "Preventive Effect of Erythropoietin on Cardiac Dysfunction in Doxorubicin-Induced Cardiomyopathy" (full text pdf link on page) http://www.circ.ahajournals.org/cgi/content/abstract/113/4/535 (see articles that refer to it too)
2006 research article "Pathogenesis of Cardiotoxicity Induced by Anthracyclines" (free registration to elsevier required for full text) (Seminars in Oncology journal) http://www.unboundmedicine.com/medline/ebm/record/16781283/abstract/Pathogenesis_of_cardiotoxicity_induced_by_anthracyclines

Exercise helps (rat heart study  ) "Voluntary exercise protects against acute doxorubicin cardiotoxicity in the isolated perfused rat heart" (full text pdf link on page) http://ajpregu.physiology.org/cgi/content/abstract/289/2/R424

I'm sure there are more links out there, e.g. Oncology Nursing Society journal article "Concurrent Therapies That Protect Against Doxorubicin-Induced Cardiomyopathy" http://ons.metapress.com/content/20363h614jr60qlw/ but even free registration doesn't give access.....

Perhaps more links later, it takes time!

[Emma]

Hi
I also have damage to the heart muscle, kidney damage which i have to take 8 magnesium tablets a day for the rest of my life.
I also developed asthma during my chemotherapy, has anyone else developed asthma?.

My salt levels were so low during chemotherapy that they had to stop due to the damage that it had caused to my body.
I am also now tone deaf and have regular hearing test done.

It is amazing what damage the chemotherapy has on your body.

take care
Emma

[Anna]

Yes, one year after my chemo (which included high levels of adriamycin) I developed very high blood pressure (at age 17) and have been on meds for that ever since. A few years ago was also having severe chest pain and ended up being on nitro tabs for coronary artery spasms as well. With my daily meds I am usually fine.

[Kristin_B]

Hello, I am 13 years out from chemo. I had adryamicin. I had an echo 2 years ago and everything seemed fine. In the past few months I am tired all the time- short of breath and my heart does these weird beats and it makes me light headed.  Should I ask to be referred to a cardiologist?

[Tara]

Kristin - I can't give you advice from experience, but I can tell you to go with your gut.  If you are having symptoms that could in any way, shape or form be related to cardiology - I would ask to either have an echo again asap OR be referred to a cardiologist.  Maybe everything will end up being some weird hormonal thing... or, perhaps it will be treatment related.  At least you will have it inspected by qualified medical personnel and appropriately treated. 

[Mary]

Kristin, the survivorship guidelines give a great overview of the heart and of symptoms of heart problems. They are located here:

http://www.survivorshipguidelines.org/pdf/HeartHealth.pdf

You could start out by mentioning your symptoms to your family doctor or even to your oncologist if you go in for your check-up soon. I know another long-term survivor who has some weird heart rhythms sometimes, but the doctors say she is okay and they follow her. So you could be totally fine, but it's always good to talk to a doctor if you're not feeling right! You can even print out the survivorship materials above to discuss with your doctor. Some may not be familiar with the effects of childhood chemos, while others are very experienced with them.

I hope that all of this information you're finding won't scare you. It's good to know what your body has been through and what to look out for, but it's also good to live your life without thinking about cancer all the time!

[Emily_T]

I was wondering if anyone else is dealing with chemotherapy induced cardiomyopathy and how it has effected your life? I was diagnosed this August after blacking out at work, I was undergoing chemotherapy at the time. It is under control and not severe at this point. I finished chemo last month and I'm ecstatic and loving the new found energy. But due to the fact that my osteosarcoma had spread to my lungs and liver and that it took so long to get it under control, I am at a high risk for recurrence and my Cardiomyopathy may make more chemo an impossibility (at least an aggressive chemo which would put me into remission again). I have my second set on post chemo scans next week and am dreading it. Has anyone had a similar experience?

[Mary]

Hi Emily,

I merged your topic with one that we already started about heart damage. I'm not sure if you saw all of these messages already, but I thought they might be helpful. Also, anyone who responds to you can do so here, and future visitors can find the information easily.

I'm sorry to hear about your cardiomyopathy. You definitely aren't alone - several of our members have also been diagnosed. It is scary to think that it could limit future treatment that you might need, but there are treatments that don't do much damage to the heart. So let's hope that if you need something in the future you will have more options than you think. I can understand your being nervous about your next set of scans. Would you write a post up about your journey so far in our journeys section? Then you can keep us updated there about how you're doing and we can respond and support you. We'll all hope to hear about your clear scans soon.

[Cari]

Good Luck with your scans!!!!  Hoping for GREAT news!