Cardiovascular disease continues to be an increasing concern among breast cancer patients. With each cardiovascular risk factor, a woman's likelihood of having a cardiac event goes up.
In this video, , leader of the Breast Cancer Program at Herbert Irving Comprehensive Cancer Center in New York City, suggests that oncologists should take care of patients as a whole after they are diagnosed with cancer.
Following is a transcript of her remarks:
We know that women are more likely to die of cardiovascular disease than they are of breast cancer after they're diagnosed with breast cancer, because so many women do well with their diagnosis, and our treatments have come so far, but that's not known to a lot of women or even to a lot of physicians. When women are diagnosed, sometimes they focus so much on their breast cancer that they forget that there are other components of their care that can even be linked to their breast cancer.
Sometimes the treatment itself can make them gain weight, which is a risk factor for breast cancer. Some treatments can increase their blood pressure, which is a risk factor, and women with known history of diabetes or high cholesterol may not focus on their medicine so much. With each cardiovascular risk factor, a woman's likelihood of having a cardiac event goes up. Knowing that they need to manage these other side effects and symptoms that they may have, these other comorbidities, is a really important component of their care.
We've shown in the past that some of the agents that cause damage to the heart are increased by some cardiac risk factors like high blood pressure. We also know that women, when they're diagnosed, stop being adherent to their medications for other things because they start to only see their oncologist and maybe fall off track in terms of seeing their primary care physician. We've shown that for even amongst women with metastatic disease, you can see that the number of cardiac risk factors you have can increase your likelihood of having a cardiac event, and that's an area where people are very focused on their breast cancer treatment. What it tells us is that we really have to think of patients as their whole being. We need to take care of all of them when they have a diagnosis of cancer.
We sometimes can pay attention to the more extreme cardiac effects -- like if you have a drop in your ejection fraction from taking medications like Herceptin, which are known complications, but rare complications. But we don't think so much about people's blood pressure when they come in to see us, or their glucose. We give a lot of patients steroids that can increase their risk for diabetes, and we don't pay enough attention to those things which can also increase their likelihood of having a cardiovascular event.