Red dresses for heart health and pink ribbons for breast cancer awareness have given millions of Americans colorful reminders of the separate tolls these diseases take on women’s lives. But not everyone is aware of the way that the illnesses work in tandem.
Heart disease — the No. 1 killer of women — can sometimes be an outcome from and complication for breast cancer treatment.1 Older women who survive breast cancer are statistically more likely to die of heart disease than of recurring cancer.1
The diseases can also take a financial toll. Based on recent statistics from the American Heart Association and the National Cancer Institute, nationwide direct medical costs were estimated at $213.8 billion a year for heart disease2 and $19.7 billion a year for female breast cancer.3
And the diseases have another thing in common. Some of the same healthy habits that can reduce the risk of one can also help prevent the other.
Dr. Laxmi Mehta, professor of cardiovascular medicine and director of Preventative Cardiology and Women’s Cardiovascular Health at The Ohio State University Wexner Medical Center in Columbus, was chair of the writing group for the wide-ranging report on the two diseases. She explained that the connection between the two existed on a spectrum.
Sometimes, the link can be direct, like when cancer can cause fluid buildup in the sac around the heart.
“Much of the time, the connection is in the cure. Radiation treatment for breast cancer, for example can lead to blocked heart arteries, heart valve issues, abnormal heart rhythms, and more in some patients,” Mehta said.
Chemotherapy and other cancer treatments can weaken the heart and lead to blood clots, high blood pressure, and other issues.
“Some treatment-related issues show up quickly; others show up years down the line,” Mehta said.
“And problems can go both ways,” she added. “Heart issues can get in the way of treating breast cancer in some patients.”
“If they get a weakened heart muscle, in some people that means they have to stop treatment for a while until the heart recovers. Or, in other people, it might mean you can't have that treatment at all, which can be emotionally taxing on a patient and the entire care team,” Mehta said.
“They're already psychologically under a lot of stress with cancer treatment, and now we're telling you, ‘By the way, your heart is a problem,’” Mehta said. “Many patients will say, ‘I don’t care about my heart – just fix the cancer now!’” she said. “But both problems will need to be addressed.”
Women with or without breast cancer can take steps to improve their odds against both diseases.
For a cancer patient, “If you already have underlying heart disease, I say see your cardiologist and keep them in the loop about what's going on. Oncologists are well aware of the cardiac side effects from oncologic treatment and are very good about consulting with cardiologists when needed,” Mehta said.
“Cancer patients also should watch what they eat,” she said.
“Many people just feel like, ‘I can just eat whatever I want. I'm on chemo.’ And that sometimes is necessary, because sometimes a lot of things aren’t palatable when you're undergoing chemo. But when your appetite is better, you want to make sure you’re trying to eat healthy foods both for the heart and cancer. Those are very important things.”
As is exercise.
“Many people think that they need to rest,” she said. “And with chemo there are going to be days where it just drags you down and you can't exercise. But the other days that you have some energy, just any little bit physical activity — it’s not, ‘Go run a mile’ or anything — is good for you.”
Breast cancer and heart disease share several manageable risk factors, such as having a poor diet, being overweight, lack of physical activity, and using tobacco.1
So, Mehta is an advocate of the American Heart Association recommendations known as Life’s Simple 7 — manage blood pressure, control cholesterol, reduce blood sugar, get active, eat better, lose weight, and stop smoking. 4
“Life’s Simple 7,” she said, “is typically what I say patients could be doing to prevent the diseases or at least make them functionally better while they're undergoing treatment.”
Things to Consider:
- If you’re a cancer patient, make sure your cardiologist is in the loop.
- Even during treatment, remember to eat right and exercise.
- You can lower your risk of heart disease and breast cancer with a healthy lifestyle.
1 “Cardiovascular Disease and Breast Cancer: Where These Entities Intersect,” Circulation, February 2018
2 “Heart Disease and Stroke Statistics — 2019 Update,” Circulation, March 2019
3 “Financial Burden of Cancer Care,” National Cancer Institute, February 2019
4 “My Life Check: Life's Simple 7,” American Heart Association, May 2018
This article was prepared by the American Heart Association (AHA). Transamerica is not affiliated with the AHA and does not control, guarantee, or endorse the information. This information does not constitute the practice of medical advice, diagnosis or treatment. Always talk to your healthcare provider for diagnosis or treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified healthcare professional immediately. If you are in the United States and experiencing a medical emergency, call 911, or call for emergency medical help immediately.