Protecting Your Heart during and after Breast Cancer

My Oncologist forced me to see a Cardiologist when he discovered Adriamycin Cytoxan (Doxorubicin) Chemotherapy and Herceptin damaged my heart.  I am so thankful he did because I have learned so much that could have gone unnoticed.

A group of Cardiologists at the University of Michigan said Nuclear Stress Tests results showed that  I suffered heart attack during Chemo and Herceptin.    I did have heart attack symptoms like arm pain, chest pain, and breathing difficulties, but thought they were chemo symptoms because chemo will cause these symptoms as well.

There are many new studies out in 2012-13 on the dangers of Chemo and/or Herceptin and severe heart damage.   These studies warn cancer survivors to look for heart problems for up to 5 or more years after you are finished with the drugs.     In most people Adriamycin Cytoxan AC Chemo (Doxorubicin) increases cholesterol, while it is more rare during Taxol.  M D Anderson, the top cancer hospital in the USA, just released some findings on why this Chemo drug causes heart failure:   http://www.mdanderson.org/newsroom/news-releases/2012/key-discovered-to-how-chemotherapy-drug-causes-heart-failure.html

Before Chemotherapy, the protocol is to have a MUGA scan or ECHO cardiogram of the heart.  Then your Oncologist monitors it every 3 months until treatment ends to make sure your Ejection Fraction (EF) does not go dangerously low.  Mine went dangerously low – it fell from 65 to 39 and has remained at 39.   This Cleveland Clinic website gives great information about EF, what is normal and what isn’t:    http://my.clevelandclinic.org/heart/disorders/heartfailure/ejectionfraction.aspx

If you are  prescribed anti-hormonal drugs such as Arimidex or other Aromatase Inhibitors  post treatment, these drugs can also raise your cholesterol.  Tamoxifen can raise or lower cholesterol depending on the person.   Normally, your Oncologist is not interested in your cholesterol levels, but your estrogen levels while on these medications.   Thankfully, my Cardiologist stays on top of this.

Chemotherapy raised my cholesterol.   It raised 36 points after Chemo even though it was normal previous to Chemo.  My Oncologist immediately placed me on a low dosage of Lipitor.  Within 2 months, my cholesterol dropped from 225 to 154 and LDL from 150 to 61.

Oncologists do not check your heart after Chemo is over.  Their job is to keep the cancer away, not be concerned about your heart.  Your General Practitioner may not be aware of the heart dangers after Chemo and Herceptin.   But you need to be concerned about your heart and take actions to protect it no matter what your age.

My recommendations:

1)   Ask your General Practitioner to monitor your heart closely after Chemo is finished.  If they are not already aware, educate them or ask them to research Chemo drugs and the heart.  Ask them to prescribe periodic cholesterol blood tests, liver tests, and additional ECHO or MUGA scans.  Check with your insurance company to see how often they will pay for this.

2)  If you have not had a Nuclear Stress Test, talk to your General Practitioner about this for their recommendations.

3)  Keep on top of this for the 5 years or more after Chemo as you are at a much higher risk than you were previously.  If symptoms show up, immediately get a referral to a Cardiologist.  They are your best line of defense!

4)  If you have any heart-related symptoms, get to your doctor or emergency room immediately.

It is doubtful I would have kept on top of the heart issues had I not been forced to do so.

I don’t want you to make that mistake.

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6 comments

  1. I’m glad you’re ok. I had a different type of chemo five years ago and I don’t have a problem but my doctor still monitors my heart twice a year. Take care of yourself.
    God bless you! Polly

  2. Thank you for this… I had the same chemos and saw my ECHO numbers drop, too… And I worry about the long-term effects. I’m sorry that you are dealing with them, too. Thank you for sharing this info!
    Warmest wishes…

  3. I just had an updated echo after 7 doses of Herceptin and my EF went from 68%-57%. I already have a cardiologist for an unrelated reason so my onc was checking to see if I should go for a visit. I am writing b/c my husband has been very supportive w/all the treatment but he doesn’t like this result and thinks it should be stopped. Dr didn’t give me a dose today. Any advice? Good articles to show my husband? I told him I have to follow Dr’s orders and he should call my onc.

  4. I had my echo right at the beginning of treatment. I’ve had 16 herceptin infusions since then. The first 12 were with chemo. Now it’s weekly. My first follow up echo was this past Thursday. I’ll ask for the results tomorrow when I go for my weekly infusion. I hate being on herceptin. Also perjeta every 3 weeks and zolodex and xgeva every 4 weeks. But it is what it is. 🙂

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