Anant Mandawat, MD, director of the Winship at Emory Cardio-Oncology Program, addresses heart health concerns for patients treated with radiation therapy.
February 7, 2019
Heart disease is the leading cause of death in the United States followed by cancer. Notably, patients with cancer have a higher risk of developing cardiovascular disease. Winship Cancer Institute of Emory University (Winship) is dedicated to addressing the intersection between these two leading causes of death with a special Cardio-Oncology Clinic, one of the few multi-disciplinary programs in the country dedicated to collaborative cardiac care for patients with cancer.
Anant Mandawat, MD, director of the Winship at Emory Cardio-Oncology Program, works with clinicians to reduce the risk of complications from heart disease during cancer treatment. Dr. Mandawat talks about heart health and radiation therapy.
What are the primary heart concerns that radiation therapy patients need to be aware of when deciding on potential treatment options?
Patients should know that pre-existing heart disease and cardiac risk factors, such as smoking, high cholesterol, and high blood pressure, increase the risk for heart disease, and this is compounded to the delivery of radiation therapy to any portion of the heart. With cancer therapy, patients and their bodies are going into battle; we do our best to strengthen their heart for the fight.
Which radiation therapy patients are most likely to experience heart complication from treatment?
Heart complications from radiation treatment can occur when a portion of the heart receives a significant radiation dose. This can occur among patients treated for Hodgkin lymphoma or breast, lung, or esophageal cancer. The most common acute complication is pericarditis, which is an inflammation of the lining around the heart.
When should a radiation therapy patient consult with a cardio-oncologist?
I would recommend seeing a cardio-oncologist if you received radiation therapy for Hodgkin lymphoma, breast, lung, or esophageal cancer and have a heart disease that is not well controlled or active cardiac risk factors like high cholesterol or high blood pressure.
Also, if you develop or experience chest pain, shortness of breath, palpitations, or swelling in the legs, before and during treatment, these are signs that you may be experiencing heart problems and should see a cardio-oncologist for evaluation.
What is done before and after radiation treatment to mitigate heart problems?
We often see patients for a pre-radiation therapy consultation to optimize their heart conditions and cardiac risk factors prior to starting treatment. After treatment, patients are at increased risk of complications. If complications develop, we aim to find them and treat them early.
Radiation therapy patients have specific screening recommendations for their heart health after therapy. Overall, by optimizing heart health before radiation therapy and screening for the disease after therapy, we protect the heart health of cancer patients.
What support options does Winship provide for radiation therapy patients who are at risk for cardiovascular issues?
At Winship, we take pride in having a team-based approach to care. For patients at risk for cardiovascular complications, we encourage them to discuss their heart health with their radiation oncologist, oncologist, hematologist, or surgeon who can refer the patient to be seen by a cardio-oncologist. In the cardio-oncology clinic, we work closely with the patient's primary team to ensure quick access for cardiovascular concerns and provide recommendations tailored to the patient's specific disease and treatment plan. Importantly, because we are all under the Winship roof, we maximize team-based discussions between providers to ensure the best outcomes for the patient's cancer and heart health.