Oncologist with 30 years of experience explains the vicious cycle of how cancer treatments harm heart health

Cancer treatments often lead to heart complications, affecting patient health and treatment. Therefore, integrated oncology and cardiology care is vital.

Cancer is one of the leading causes of deaths worldwide, with nearly 10 million deaths in 2020, according to the World Health Organization data. This has driven several research efforts to develop therapeutic strategies and treatments.

However, despite modern developments, conventional chemotherapy and targeted or immune therapies have been known to be associated with substantive adverse effects.

Cancer treatments and heart complications

Taking to X on January 17, physician and scientist Eric Topol highlighted this health concern by sharing a study published in the Journal of Clinical Investigation. “The vicious cycle of heart complications from many cancer treatments,” he captioned the post.

To understand why such complications, such as myocardial (heart muscle) dysfunction, arrhythmias, or vascular problems, arise with cancer therapies, HT Lifestyle spoke with Dr Mahesh Bandimegal, senior consultant, surgical oncology, HCG Cancer Hospital, K R Road, Bangalore.

"As a clinician with over three decades of experience in oncology and cardiology, I have witnessed a concerning and often under-recognised reality: many life-saving cancer treatments can initiate a vicious cycle of heart complications that profoundly impact long-term patient health,” Dr Mahesh noted.

Many life-saving cancer treatments can initiate a vicious cycle of heart complications that profoundly impact long-term patient health.

‘Cancer therapies can directly or indirectly injure the heart…’

He stated that several commonly used therapies—such as anthracycline-based chemotherapies, HER2-targeted agents, radiation to the chest, and newer immunotherapies—can directly or indirectly injure the heart.

“The initial insult may appear subtle: a mild reduction in cardiac pumping function, transient rhythm disturbances, or early vascular inflammation. However, if not identified and managed promptly, these changes can progress into chronic heart failure, coronary artery disease, or persistent arrhythmias,” Dr Mahesh cautioned.

What makes this cycle ‘vicious’, according to the oncologist, is the interplay between cancer treatment and cardiovascular vulnerability. He explains, “Patients with pre-existing risk factors—hypertension, diabetes, smoking history, or advanced age—are more susceptible to cardiac injury.”

Once the heart is compromised, the body’s ability to tolerate further cancer therapy diminishes.

Moreover, he notes, “Once the heart is compromised, the body’s ability to tolerate further cancer therapy diminishes, sometimes forcing clinicians to reduce or discontinue potentially curative treatments. This, in turn, can affect cancer outcomes and quality of life, creating a difficult clinical balance.”

The solution, Dr Mahesh elaborates, lies in a proactive, collaborative approach. He suggested measures that can significantly reduce long-term damage, including:

• Baseline cardiac assessment
• Routine monitoring during therapy
• Early intervention with cardioprotective medications

He adds, “The emerging field of cardio-oncology emphasises this partnership between oncologists and cardiologists, ensuring patients not only survive cancer, but also maintain a healthy, functional heart for years to come.”

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.