Two cardiologists (heart doctors) who work with cancer patients, a researcher and a breast cancer patient navigator joined Zero Breast Cancer’s October 2022 webinar to offer important information about managing heart health during and after breast cancer treatment. One of the panelists is also a breast cancer survivor. They gave an overview of the current treatments most likely to cause heart problems and what can be done to prevent or limit them.

Our speakers focused on two types of chemotherapy linked with heart disease: trastuzumab (Herceptin) and anthracycline drugs, which led to a doubling or tripling of risk of heart failure and cardiomyopathy, especially when used together. Hormonal therapies (tamoxifen, raloxifene and aromatase inhibitors) are also associated with heart problems. The increase in the risk of heart diseases depends on many factors, such as age, family history, blood pressure, having obesity, number and length of hormones used, and smoking.

Women who receive radiation, especially on the left side, are more likely to develop problems with the heart. A webinar participant asked about ways to protect the heart during radiation.Recommendations include:

  • limiting the amount of radiation (shorter course of radiation),
  • using breath-hold and breathing gating techniques,
  • prone positioning (lying on your stomach), and
  • using technologies to guide the radiation beam and shield the heart.

What we can do

The panel members emphasized ways that individuals can prevent or manage heart disease, which can be supported. They described a pilot Cardiac Rehabilitation program at Zuckerberg San Francisco General through the University of California-San Francisco and Cardio-Oncology Program starting at Kaiser Permanente Northern California. The patient navigator offers individual advice and facilitates support groups, providing a safe space to discuss how to adapt and adopt healthy behaviors along with social and emotional support.

Our panel also offered some resources for eating healthy, being physically active and managing stress.

Nutrition and diet

Physical activity and exercise

Managing stress

Sleep is also important for cancer risk and heart health. Not getting enough sleep can affect the heart directly, and also indirectly by influencing our choices about food and exercise.

Check out this recent blog for more information on heart health and breast cancer.

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