How to protect your heart during chemo

Professor Malcolm Walker, Consultant Cardiologist at University College Hospital London, says:

We know that chemotherapy for cancer can affect the heart, and so the best approach is to avoid that happening in the first place, if possible.

I work in a new sub-speciality of cardiology, called cardio-oncology, and my job is to make sure that if you are having chemo, you are well enough to have the treatment, and any problems with your heart caused by the chemo are treated.

Chemotherapy is a powerful weapon against cancer, but some drugs can cause cardiotoxicity, which can increase the risk of heart failure. Find out more about the research we're funding to prevent this side effect.

The overall aim is to make sure you can have the best possible cancer treatment without interruption. Being as fit and as well as possible before you start chemo is important. You can help yourself by eating well, being active, and making sure your blood pressure and cholesterol are well controlled, as well as diabetes if you have it. For most people, that means taking your medicines as prescribed.

At the very beginning we need to identify who might be at risk of developing heart problems during chemo because of their medical history. That means people who have existing heart problems, who are at risk because of high blood pressure, diabetes or high cholesterol, or who have had a heart attack. We aim to control those factors, if possible, before the chemo starts, so you limit the risk to the heart at the outset.

You can help yourself by eating well, being active, and making sure your blood pressure and cholesterol are well controlled

We know that people who are fit before they start chemo tend to do better. So it’s also important to exercise before, during and after chemo – to protect your heart, and to improve recovery after treatment.

• Visit our activity section for tips and inspiration on getting fitter

What side effects can chemo drugs have on the heart?

Different chemo drugs can affect the heart in different ways. They can:

• affect the way the heart pumps
• cause blood pressure to rise
• cause heart muscle inflammation (myocarditis)
• lead to heart rhythm problems.

In the past, people with heart problems may have been prevented from having chemo or their course was interrupted, with poor effects on their cancer. Nowadays, with risks identified early we may be able to give them medications to protect their heart, to allow them to complete their cancer therapy.

We can monitor their heart during chemotherapy, and some people will need longer term cardiology follow-up after their cancer treatment has finished.

By working closely with our colleagues in oncology, we may be able to anticipate which problems to look out for and adjust treatments where necessary, and give medication to protect the heart if needed.

Find out more about cancer and the heart in our Live & Ticking webinar:

• If you have any questions or concerns about cancer treatments, call the free Macmillan Cancer Support line on 0808 808 00 00.
• If you have questions about your heart health, call the BHF Heart Helpline.

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