Cardiovascular disease; In one of the largest studies of its kind, the research team, led by the London School of Hygiene & Tropical Medicine, analyse the medical records of more than 630,000 people in the UK, including over 100,000 survivors of a range of cancers. They found raise risks of blood clots forming in the veins among survivors of most cancers; ranging from approximately a two-to ten-fold increase in risk for different cancer sites. Risks decreased over time but were still elevated for more than five years after the cancer diagnosis.
Survivors of half of the 20 cancers studied also face increase risks of heart muscle damage, known as cardiomyopathy, and heart failure. For example, survivors of blood, oesophagus, lung, kidney and ovarian cancers were more than one and a half times more likely to experience cardiomyopathy or heart failure than people with no prior cancer. An increase risk of coronary artery disease and stroke was found in some cancer survivors; hence including those with prior blood cancers.
Heart muscle damage
The researchers stress that for many people the overall risks will still be low; hence particularly for younger cancer survivors; but say the findings highlight the need for new strategies to prevent and manage heart and circulation problems in cancer survivors; hence including a need to raise awareness among GPs of the raise risks. While the researchers could not definitively identify the causes of the increase risks; the team’s analysis suggests that exposure to cancer treatments such as chemotherapy is likely to play a key role.
Lead author Helen Strongman from the London School of Hygiene & Tropical Medicine said: “Over recent decades cancer treatment and management have improve substantially; so resulting in a large and growing population of long term cancer survivors. Around half of those diagnose with cancer in develop countries are now expect to survive for more than 10 years.
However, there are concerns that there may be increase long term risks of cardiovascular disease following cancer diagnosis; drive by treatment side-effect effects and the potential impact of the cancer itself.” While previous studies have demonstrate the short- to medium-term increase risk of cardiovascular disease from some specific cancer treatments; there have limit data on the overall and long-term differences in cardiovascular risk between cancer survivors and those who have never had cancer.
Range of cardiovascular disease
To address this, the team brought together anonymise data from primary care, hospitals, cancer registries, and death certificates; hence to quantify the absolute and relative risks of a comprehensive range of cardiovascular diseases; which in survivors of the 20 most common adult cancers compare with cancer free general population controls. The research also account for other risk factors for cardiovascular disease; so such as older age, smoking and body mass index.
The senior author of the study Professor Krishnan Bhaskaran from the London School of Hygiene & Tropical Medicine said: “With treatment for cancer becoming more effective; they must start thinking about living beyond cancer and improving the health of survivors. Our work reveal raise risks of various cardiovascular diseases in cancer survivors. These findings are important because those affect might benefit from preventative measures and earlier interventions to reduce the impact.
“If patients, primary care doctors, and specialists are more aware of the potential for increase cardiovascular risks in this patient group; they might detect problems earlier and improve outcomes. There is limit guidance at present to help doctors manage cardiovascular risk in cancer survivorship; also further evidence is need on whether routine monitoring or additional preventative measures; which would benefit those with the highest risks.”
The authors acknowledge limitations of their study including that there was only limit information; which available about the anti-cancer treatments that patients had received. Although the research team had some information on whether patients had receive chemotherapy, radiotherapy, and surgery, there was no detail information on specific chemotherapy drugs, radiotherapy doses, or surgery procedures.