HEART DISEASE LINKED TO CANCER: TREATMENT AND PREVENTION

Cancer and cardiovascular disease (CVD) are two of the leading causes of death worldwide. While they may seem like two separate health concerns, recent research has shown a strong link between the two.

In this article, we will explore the connection between cancer and cardiovascular disease and how patients with either condition can lower their risk.

Is Cancer Linked to Cardiovascular Disease and Mortality?

Almost all types of CVD linked to cancer involve plaque buildup in the arteries, most often leading to atherosclerosis and coronary heart disease.

This was proven in several studies, including a large-scale review of 27 million cancer patients. The findings reveal that atherosclerosis increases the risk of contracting cancer of any type by as much as 13%. This risk was most prominent for cancers of the blood, lung, bladder, liver, and colon.^[1]

In a study conducted on over 224,000 cancer patients, the risk of developing cardiovascular disease within 11 years from diagnosis was also shown to be much higher for almost every type of cancer (barring skin and bone cancers).

Those with cancer are more than 3 times likelier to suffer from a pulmonary embolism event (blood clot blockage of a major artery) than those without cancer. They are also at a higher risk for stroke and heart failure, with up to a third of patients succumbing to cardiovascular-related mortality. These results were shown to arise independently of treatment. However, cancer treatments are also linked to a higher risk of developing cardiovascular disease due to their effects on blood vessels.

Studies have also shown that cardiovascular disease increases cancer risk. This is especially true for atherosclerosis and coronary artery disease. Patients with these conditions were 26.3% more likely to develop cancer than their healthy counterparts.

Systemic Inflammation, Tumor Microenvironment, and Heart Disease

The tumor microenvironment refers to the conditions within and around a tumor that can affect its growth and spread. These conditions include low oxygen levels, excessive growth factors, and chronic inflammation. Interestingly, these same factors are also associated with the development of heart disease. For example, low oxygen levels can lead to the formation of plaques in the arteries, while excessive growth factors can promote the growth of blood vessels in the heart.

Chronic inflammation is also a common feature of both cancer and heart disease. Damage to the arteries causes inflammation and the release of growth factors, which allow for repair. If this occurs repeatedly for a long period of time, inflammation can lead to faulty immune responses and DNA damage. When coupled with an increase in growth factors, this can lead to the development of a tumor.

Understanding the overlap between tumor microenvironment factors and heart disease factors can help researchers develop strategies for preventing and treating both conditions.

Risk Factors that Link Cancer to Heart Disease

Cancer and CHD share several joint risk factors that do not necessarily improve with currently available treatment options, such as^[2]:

• Aging
• Physical inactivity
• Obesity
• Hypoxia (low oxygen levels) and causes of low oxygen, such as smoking or respiratory conditions
• Family history of either condition
• High blood pressure and high cholesterol levels
• Diabetes and blood sugar issues

All of these risk factors contribute towards vascular strain, blood vessel damage, inflammation, and immune dysfunction, which can contribute towards either heart disease or tumor formation.

Specific Cancers and Their Link to Cardiovascular Disease

While some risk factors are the same between heart disease and cancer of any type, specific types of cancer are associated with heart disease more often than other types due to their location, causes, and specific symptoms.

A few of the most common associations are discussed below:

• Liver cancer: The prevalent cause of liver cancer is non-alcoholic fatty liver disease, which leads to the overproduction of fats in the liver. Naturally, this increases the risk of heart disease and is often accompanied by high cholesterol levels and blood pressure.^{[3] [4]}
• Lung cancer: Lung cancer and heart disease share a strong bidirectional relationship, especially when there is a family history of lung cancer. Those with lung adenocarcinoma are more likely than other patients with lung cancer to develop heart disease.^[5]
• Colon cancer: Individuals with heart disease, obesity, or elevated blood pressure are more susceptible to colon cancer. Moreover, in patients with colon cancer, cardiovascular events were the major cause of all non-cancer mortalities.^[6]
• Leukemia: Due to particular gene mutations (CHIP mutations) in red blood cells, which increase vascular inflammation, acute myeloid leukemia has been demonstrated to increase the risk of cardiovascular events.^[7]
• Lymphoma: Patients with Hodgkin's Lymphoma are a lot more susceptible to contracting secondary cancers and diseases, including a 2-4-fold increased risk of contracting heart disease. To these patients, the toxic effects of therapy are also estimated to last for up to 25-35 years, which possibly adds to their overall poor prognosis^[8].

Cancer Treatment Is Also Linked to Cardiovascular Disease Risk

One of the main reasons why cancer and cardiovascular disease are linked is due to the cancer treatment itself. The heart and blood vessels can be damaged due to chemotherapy and radiotherapy, which are two common treatments for cancer. This damage accumulates over time and can lead to various cardiovascular conditions, such as heart failure, coronary artery disease, and arrhythmias.

Radiation therapy to the chest area raises the risk of heart disease and can damage the heart. This is very pronounced in those receiving radiotherapy for breast cancer. As it turns out, left breast radiation and heart damage have become a very prominent issue for women with breast cancer, almost doubling the risk by comparison to right breast radiation. Those who have breast cancer are far more likely than the average cancer patient to have heart problems because of the tumor's proximity to the heart.

Many chemotherapy drugs are also cardiotoxic, which means that they increase inflammation in the blood vessels and heart. Unfortunately, this is part of what makes them so effective, as they target the blood supply to tumors. Cardiotoxic chemotherapy medications may also raise the chance of blood clots, which can result in strokes and heart attacks.

The combination of chemoradiotherapy proved to be a lot more cardiotoxic than either therapy alone.

Most studies also highlight how higher dosages are not always better for the patient and can contribute towards the onset of cardiomyopathy within several months to a year, especially in older, more susceptible patients who live with several risk factors.

When opting for treatment for cancer, it is very important to discuss your cardiovascular risk profile with a qualified specialist and to have them design an appropriate protocol that moderates the dosages accordingly. Patients at high risk of cardiovascular disease may benefit from a prophylactic cardiovascular protocol or prescription heart medication.

CVD and Cancer Prevention: Reduce Your Risk

While the link between cancer and cardiovascular disease may seem daunting, there are steps you can take to reduce your risk.

Quit Smoking

One of the main risk factors for cardiovascular disease and cancer is smoking. You may drastically lower your risk of contracting these diseases by giving up smoking.

Stay Physically Active

Being sedentary increases the risk of cardiovascular disease and cancer. Maintaining an active lifestyle can lower your chance of contracting certain illnesses.

Obesity is another major risk factor for both cancer and cardiovascular disease. Regular exercise and a balanced diet help maintain a healthy weight, by which you can lower your chance of acquiring these diseases.

Manage Stress

Stress can contribute to the development of both cancer and cardiovascular disease. You can lower your risk by exercising, using relaxation techniques, and seeking support when you need it.

Get Regular Cardio Check-Ups

Regular check-ups with your doctor can help detect any early signs of cancer or cardiovascular disease. Early detection can lead to better treatment outcomes and reduce the risk of complications.

If undergoing cancer therapy, it is very important to go for regular cardiovascular screenings and to communicate any heart disease symptoms with your doctor. These may include:

• Frequent heart palpitations or irregular heartbeat
• Chest pain
• Shortness of breath
• Dizziness or disorientation
• Exercise intolerance
• Difficulty standing up from sitting or changing positions without feeling light-headed

Consult with your oncologist if you experience these symptoms, and have them collaborate with a cardiologist if necessary to adjust your protocols.

Supplement with Antioxidants

Antioxidants are considered beneficial for lowering inflammation, yet they may also stand in the way of treatment. Some antioxidant therapies have been considered beneficial complementary approaches for those undergoing radiotherapy and chemotherapy^[9]. If you are displaying symptoms or are worried about developing CVD, it can be a good idea to discuss possible antioxidant options with your oncologist that can lower the risk while supporting your protocol.

Cancer survivors may also wish to supplement on antioxidants and maintain a steady daily intake of essential vitamins and minerals to lower their long-term CVD risk. It can be a good idea to consult with a heart specialist and a dietician about specific supplements that may promote long-term cardiac regeneration.

Conclusion

There is a complicated relationship between cardiovascular disease and cancer, with both diseases sharing risk factors that can increase the risk of the other. By understanding this link and taking steps to reduce your risk, you can improve your overall health and well-being. Stay on top of your health and get personalized advice from your physician.

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