Today, cancer patients are living longer thanks to these drugs, but they may be at increased risk of dying of heart disease caused by these same cancer therapies.
While proven to be effective, some chemotherapy drugs commonly used to treat cancer are cardiotoxic, which means they can decrease heart function and sometimes cause permanent damage.
While doctors are aware of these effects, few programs are designed to monitor and treat cardiac problems in these patients.
Spectrum Health’s cardio-oncology program was the first of its kind in Michigan and is one of a dozen programs in the nation that monitors and treats patients receiving cardiotoxic cancer therapies.
Cardiac complications are the second most common cause of death for cancer patients, after the cancer itself. For example, among breast cancer patients who receive anthracycline chemotherapy and trastuzumab (Herceptin) therapy, more than 20 percent will develop cardiotoxicity.
“I was focused on my cancer treatment so the idea my heart could be at risk came as a big surprise,” said Nicole May, 42, who was treated for breast cancer at Spectrum Health in 2012.
“My heart was monitored throughout my treatment,” she said. “When my heart function dropped to a point that my doctors were concerned, I had to stop my Herceptin treatment temporarily so we could get my heart function back up and then finished treatment.”
May was evaluated and treated at Spectrum Health’s cardio-oncology program run by Spectrum Health Medical Group cardiologist Helayne Sherman, MD, PhD, and Marianne Melnik, MD, a Spectrum Health Medical Group breast surgeon and surgical oncologist.
They launched the program in Spring 2012, introducing it to oncologists and hematologists whose patients receive cardiotoxic therapies.
“While many oncologists provided heart screening for their patients throughout treatment, there were no standards in place for monitoring and long-term follow up,” Dr. Sherman said.
Spectrum Health’s program monitors cardiac function before, during and after chemotherapy, and uses cardio-protective medications to improve or stabilize heart function when there is evidence of cardiotoxicity.
One of the major goals of the program, Dr. Sherman said, is for patients “to continue with their cancer therapies with minimal to no interruption in therapy.”
Doctors first establish a baseline echocardiogram to check heart function before the patient starts cancer treatment, followed by a series of echocardiograms during and after completion of cancer therapy. Ongoing follow-up and screenings occur for each patient, depending on their cardiac condition and the therapies they received.
Echocardiograms are performed at multiple Spectrum Health locations, including the Cancer Center at Lemmen-Holton Cancer Pavilion.
May has finished her cancer treatment, but continues to take a heart medication to keep her heart functioning in a healthy range. And she continues to see Dr. Sherman regularly.
“This partnership makes it possible for patients to receive the cardiac care they need, yet still finish their cancer treatment, which will improve survival rates,” Dr. Melnik said.
Each year, about 700 women are diagnosed with breast cancer at Spectrum Health.
“This program will potentially save thousands of lives over time for breast cancer patients alone—not to mention other cancer patients who receive cardiotoxic medications,” she added.
Drs. Melnik and Sherman would also like to pursue clinical research to advance the program. For example, determining preventative approaches prior to cancer treatment, looking at a patient’s biomarkers or predisposition to cardiac issues, and following patients long term could help influence care in the future.
There is still a great deal to learn about the short- and long-term effects of cancer therapies and their impact on cardiac health, Dr. Sherman said.
“We’re proud to be among the few centers in the country offering such a program,” she said. “This is an example of what collaboration, innovation and clinical research can bring to patients.”
As for Nicole May, she is grateful that her oncologist, Amy VanderWoude, MD, involved her in the program.
“I had no history of heart issues and I didn’t realize the side effects of chemotherapy could be so damaging so quickly,” she said. “I have peace of mind knowing my heart is being watched carefully, possibly for the rest of my life.”
The cardio-oncology program at Spectrum Health is supported by generous donors in the community. Give today.