What’s more likely to cause mortality in older breast cancer patients — breast cancer itself or heart disease? The assumption might be that breast cancer itself is the more likely culprit. But that’s not correct. It turns out that older breast cancer patients are more likely to die from heart disease than from their cancers! Plus, once completing treatment, there’s a greater chance for older breast cancer patients to experience heart problems than a recurrence of breast cancer.
So, breast cancer patients — especially older ones — need to pay special attention to their hearts. And not just on Valentine’s Day.
“Why is this?” you may ask. We suggest a few explanations: Treatments for postmenopausal breast cancer patients have decreased risks of dying from the cancer itself. And certain conventional treatments can cause heart damage (which can be diminished with integrative interventions to be discussed.) Plus, many breast cancer patients have personal risk factors for cardiac disease when first diagnosed: hypertension, a sedentary lifestyle, or being overweight.
Adjuvant chemotherapy comes with different risks. Since most patients decrease exercise during chemo, their aerobic capacity and cardiac fitness decline, often leading to problems like fatigue, weight gain, and muscle loss. Another consequence is higher levels of inflammation – this too fuels heart problems. And chemotherapy-induced menopause may change the hormonal environment, which can bring cardiac complications.
Although these concerns might worry older breast cancer patients, there are positive steps for enhancing cardiac health. First, patients should insist on cardiovascular risk assessments in their regular follow-ups. And you can decrease damage to the heart caused by treatments with certain healthy lifestyle changes (that we will suggest.) Moreover, hypertension, which can increase the risk of cardiac side effects from chemo drugs, might be controlled naturally or with medications. That is, drugs that lower cholesterol and blood pressure may also be in order.
In animal studies scientists found that aerobic exercise during treatment consistently reduced heart damage by increasing natural antioxidants in the heart. However, since specific data on types and schedules of exercise are still lacking, we recommend that women receiving treatment emphasize stretching and gentle weight training, with some interval aerobic exercise if OK’d by a physician. We also urge at-risk patients to begin boosting their moderate exercise so that they can reach a daily total of 60 or even 90 minutes. Additionally for cardiac protection we advise: Eat larger quantities of vegetables and fruit, fish (not fried, please), whole grains, legumes and some nuts as well as other high-fiber foods, while you reduce foods high in saturated fat, cholesterol, sodium, red and processed meat, and sugar — especially sugar-sweetened beverages. We recommend following our treatment support diet, along with selected supplements.
It seems unfair that breast cancer patients also need to become fully informed, long-term advocates for their heart health – but it is essential. The Block Center has a dedicated and skilled team to help you care for your heart after breast cancer treatment. If facing an increase in cardiac risk, you can contact our office at 847-492-3040, and one of our patient advocates will discuss making an appointment at the Block Center.