Leading Cause of Death in Patients With Breast Cancer
It may be surprising to some, but the leading cause of death in patients with breast cancer is heart disease.
“It’s no longer that they are diagnosed with breast cancer and they are dying of breast cancer. They are dying of heart disease,” said Sandra Cuellar, PharmD, BCOP, of the University of Illinois Hospital and Health Sciences System in Chicago, at the 13th Annual Conference of the Hematology/Oncology Pharmacy Association. Heart failure and other cardiotoxicities are occurring in women in their 40s and 50s after treatment with radiation, anthracyclines, and HER2-receptor antagonists, added Dr. Cuellar, who is Clinical Assistant Professor and Clinical Oncology Pharmacist at the University of Illinois.
However, if women receive cardioprevention within 2 months after cancer treatment, she noted, the cardiomyopathies may be mitigated or perhaps in some cases reversed. Furthermore, the change in the lifetime cumulative dose of anthracyclines—from between 400 and 500 mg/m2 to 250 mg/m2 or more—may help to mitigate some of the risks. “We have to retrain ourselves to this new threshold,” stated Dr. Cuellar. “We know we are going to cause cardiotoxicity, but there may be something we can do about it.”
Dr. Cuellar believes the cancer-cardiotoxicity statistics are changing the relationship between oncologists and cardiologists. With cardio-oncology emerging as a subspecialty, she recommends patients see a cardiologist before, during, and after treatment for cancer.