Cured of cancer – watch your heart
According to a new study, one in ten patients with any cancer does not die from cancer, but from problems with the heart and blood vessels. For some cancers, such as breast, prostate, endometrial, and thyroid cancers, approximately half of cancer-cured patients will die from cardiovascular disease (CVD).
Nicholas Zaorsky, Kathleen Sturgeon and their colleagues from the Penn State College of Medicine and the Penn State Institute of Oncology compared the entire U.S. population with more than 3.2 million patients who were diagnosed with cancer between 1973 and 2012. They used information contained in the Surveillance, Epidemiology and End Results (SEER) database to estimate mortality from cardiovascular diseases, which included heart disease, hypertension, stroke, arterial thrombosis and aortic lesions. They adjusted the factors to weed out those that could distort the results – age, race, gender. For the same purpose, 28 different types of cancer were included in the study.
Of 3,234,256 cancer patients, 38% (1,228,328) died of cancer, and 11% (365,689) died of cardiovascular diseases. Among them, 76% were heart diseases. The risk of death from CVD was highest in the first year after cancer diagnosis and among patients younger than 35 years.
The majority of deaths from cardiovascular diseases occurred in patients with breast cancer (a total of 60,409 patients) and prostate cancer (84,534 patients), as they are among the most common cancers diagnosed. In 2012, 61% of all cancer patients who died from CVD suffered from breast, prostate or bladder cancer.
The proportion of cancer survivors, but those who died from cardiovascular diseases, was highest with lesions of the bladder (19% of patients), larynx (17%), prostate (17%), uterus (16%), intestines (14%) and breast (12%).
Patients who died from cancer, not from cardiovascular diseases, were sick with the most aggressive and difficult to treat diseases, such as lung, liver, brain, stomach, gallbladder, pancreas, esophagus, ovary and multiple myeloma.
It was also found that among the surviving patients with any type of cancer diagnosed before the age of 55, the risk of cardiovascular death was more than ten times higher than in the general population.
Surviving patients with breast, laryngeal, skin, Hodgkin's lymphoma, thyroid, testicular, prostate, endometrial, bladder, cervical and penile cancers are equally likely to die from both cardiovascular diseases and a recurrence of primary cancer. The risk of death from cardiovascular diseases is several times higher than in the general population in the first year of diagnosis; sometimes it decreases, but for most cancers this risk is increased, since survivors have been observed for ten or more years. Awareness of cancer–winning patients about this risk can encourage them to a healthy lifestyle - this reduces the risk of not only cardiovascular diseases, but also cancer recurrence.
The reason why cancer patients are more at risk of death from cardiovascular diseases during the first year after diagnosis may lie in the accidental detection of other diseases in the process of cancer diagnosis. This phenomenon can also be explained by aggressive antitumor treatment that follows the diagnosis.
The authors hope that the results of the study will increase patient awareness and alertness of primary care physicians, oncologists and cardiologists to reduce the risk of cardiovascular diseases among cancer patients and provide timely, active and coordinated cardiovascular care.
This study is by far the largest and most comprehensive study on mortality from cardiovascular diseases among patients with 28 types of cancer, with data for 40 years. Smaller-scale studies have assessed the risk of death from cardiovascular diseases in certain specific cancers, but none included so many types of tumors with such a long follow-up period.
Limitations of the study include the lack of data on the type of treatment that patients received. There was also no analysis of treatment methods that could be most toxic to the heart and blood vessels. In addition, the SEER database does not contain information about concomitant diseases and risk factors, such as smoking, alcohol consumption, obesity. Finally, the role of socio-economic status in the risk of cardiovascular death after cancer diagnosis has not been investigated. The study was conducted among the US population, so the risks may vary among different groups of the population. The authors believe that their results are most applicable to Canada, Europe and Australia.
Despite the shortcomings of the study, it reliably proves that after cancer treatment, the risk of mortality from cardiovascular diseases is on average 2-6 times higher than in the general population. The risk of CVD throughout cancer therapy includes an acute phase (early risk) and a chronic phase (late risk). In view of such serious and persistent consequences, it is necessary to prevent heart and vascular diseases before starting any cancer therapy and continue it throughout the patient's life.
Article by K.M.Sturgeon et al. A population-based study of cardiovascular disease mortality in US cancer patients is published in the European Heart Journal.
Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru according to the European Society of Cardiology: Cancer patients are at higher risk of dying from heart disease and stroke.