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Posted by on Sep 16, 2019 in Non-Hodgkin lymphoma | 0 comments

In a nutshell

This study investigated if there is a higher risk of cardiovascular disease (CVD) in cancer survivors. 
They found that cancer survivors have a higher risk of CVD.

Some background

Improved cancer detection and treatment has increased the rates of survival. The number of cancer survivors living for more than 10 years is growing. Some cancer treatments have been associated with heart side effects. Chemotherapy (CT) and radiotherapy (RT) are both linked to these side effects. 

Cardiovascular disease (CVD) is the term for conditions that affect the heart and circulatory system. Some studies suggest that cancer treatment can later lead to CVD. Other studies show no association. It is unclear if there is an increased risk of CVD in cancer survivors.

Methods & findings

This study included 108,215 cancer survivors. They also included 523,541 patients with no history of cancer (control group). Patient data were obtained from a database. Information on CVD occurrence, hypertension (HYT), smoking and body mass index (BMI; a measurement of weight in relation to height) were compared. 

HYT, CVD, and chronic kidney disease were slightly more common in cancer survivors. There was an increased risk of blood clots (thromboembolism) in cancer survivors. This risk was higher in 10-years survivors of non-Hodgkin lymphoma (NHL; by 3.94 fold), melanoma (my 2-fold), and colorectal cancer (by 1.61-fold). This risk was lowest in survivors of breast, bladder, and prostate cancer. 

Cancer survivors also had a higher risk of heart failure (HF) and abnormal heart rhythm. Cardiomyopathy (weakened heart muscle) risk was also higher in cancer survivors. Patients with blood cancers had higher risks of HF and cardiomyopathy (1.94-fold in NHL; 1.77-fold in leukemia, and 3.29-fold in multiple myeloma). There was also an increased risk of coronary artery disease (CAD; impaired blood flow through the arteries supplying the heart) and stroke in cancer survivors. 

Blood cancers were linked to higher CVD risks than other cancers. The risk of blood clots, HF, and cardiomyopathy was higher in younger survivors with no previous history of CVD. This risk reduced over 10 years after the cancer diagnosis but still remained significantly high. CT was associated with a higher risk of blood clots, heart failure and cardiomyopathy compared to RT. 

The bottom line

This study concluded that cancer survivors have a higher risk of CVD.

The fine print

This study did not include information on the CT drugs used or RT regimen. Data on cancer recurrence was not included in this study. More investigation is needed. 

What’s next?

If you have any concerns regarding CVD risks, please consult with your doctor. 

Published By :

Lancet (London, England)

Date :

Aug 20, 2019

Original Title :

Medium and long-term risks of specific cardiovascular diseases in survivors of 20 adult cancers: a population-based cohort study using multiple linked UK electronic health records databases.

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