Your heart after childhood cancer

Your heart after childhood cancer

There is some important information for you to know if you have had anthracycline chemotherapy or radiation to your chest. 

Key points to remember about your heart after childhood cancer

This page is written for young people who have had cancer treatment.

  • using anthracyclines and radiation to treat some cancers has resulted in significantly increased cure rates
  • these therapies can also affect the heart, either during treatment or up to many years after treatment has finished
  • it depends on how much treatment you received and how often you received it - it also depends on your age at the time of treatment

Which childhood cancer therapies can affect my heart?

Using anthracyclines and radiation to treat some cancers has resulted in significantly increased cure rates. But these therapies can also affect the heart.

Using anthracyclines and radiation to treat some cancers has resulted in significantly increased cure rates. But these therapies can also affect the heart, either during treatment or up to many years after treatment has finished.

Like some of the other possible late effects you might have read about, it depends on how much treatment you received and how often you received it. It also depends on your age at the time of treatment.

What are the chemotherapy drugs that can affect my heart?

Anthracyclines are a group of chemotherapy medicines that are used to treat a variety of cancers. Those most commonly used in children's cancer treatment are:

  • doxorubicin
  • daunorubicin
  • epirubicin
  • idarubicin
  • mitozantrone

How do the anthracycline drugs affect my heart?

Anthracyclines can cause damage to the muscle cells of the left ventricle. Over time, this can lead to thinning of the outside wall or muscle of the left ventricle, resulting in a stiff, inflexible left ventricle. The medical term for this condition is cardiomyopathy (cardio = heart, myo = muscle, pathy = weak or abnormal).

Cardiomyopathy makes it harder for your heart to pump blood and deliver it to the rest of your body. If diagnosed, it can be treated successfully with medication.

From studies, we know that patients treated with moderate to high dosages of anthracyclines are at higher risk. Chest radiation together with an anthracycline further increases the risk.

Females and survivors treated at a younger age (before 5) are generally more likely to have problems than males or survivors treated at an older age.

How does radiation to the chest affect my heart?

Most people who have radiation to the chest will not have a problem, but for some, high dose radiation can damage the heart muscle, heart valves or the coronary arteries. Damage to the lining of the blood vessels (becoming stiff and roughed up) can lead to the formation of blood clots or blockage of the vessels.

How will I know if my heart is affected after childhood cancer?

Remember ... everyone is different and your oncologist is the best person to talk to about your individual risk.

An echocardiogram is an ultrasound (scan) of the heart and it can find any problems including cardiomyopathy caused by anthracyclines. You may have already had one or more echocardiograms. If you are at higher risk of problems you may have an echocardiogram every few years until you are an adult. If you only had a low dose of anthracyclines or radiation you may only need one or two. If the scan shows you have a problem, you will get an appointment with a cardiologist. The cardiologist will check your heart and if necessary, offer you medication that helps improve the function of the heart muscle.

Remember ... everyone is different and your oncologist is the best person to talk to about your individual risk.

What can I do to stay healthy after childhood cancer

As people get older, their risk of heart disease increases regardless of what treatment they might have received. Taking care of yourself by keeping fit, having a healthy diet, not gaining too much weight, and having regular health checks (especially after discharge from your LEAP clinic) are all very important ways of reducing your risk of heart disease.

  • make sure your healthcare provider knows the treatment you had, so they can watch your heart health (remember to give them a copy of your treatment summary or health passport)
  • while regular exercise is great for you and your heart, check with your LEAP team or family doctor before you start any isometric exercise such as heavy weight lifting or power lifting - weight lifting with high repetition and low weights is usually OK
  • recreational drugs like cocaine can cause life-threatening tachycardia (rapid heart rate) and irregular heartbeat, especially if a heart has been damaged by anthracyclines or radiation – don't do it!
  • smoking increases the risks of heart attack - don't smoke!

All the pages in the childhood cancer section of this website have been written by health professionals who work in the field of paediatric oncology. They have been reviewed by the members of the National Child Cancer Network (NZ). Medical information is authorised by the clinical leader of the National Child Cancer Network.

This page last reviewed 30 November 2016.
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