Pamela S. Douglas, M.D., chief of cardiology at Duke University and co-author of the JACC paper, said that the greatest damage comes from a breast cancer treatment mainstay: chemotherapy. Douglas always felt that “the benefit of saving lives outweighed the risks and were just part of the accepted cost.” But with the success of treatment and growing survivor numbers, Douglas and her colleagues are urging doctors to take the long view when deciding on a woman's breast cancer treatment. First treat the cancer, but don't forget about cardiovascular health down the road.
Chemotherapy is a systemic therapy that makes use of drugs to treat cancer. Prior to a surgery, chemotherapy may be used both to reduce the size of the breast tumor and to destroy cancer cells wherever they may be. After the surgery, chemotherapy works throughout your system to kill cancer cells that may have spread throughout your body. Chemotherapy affects the whole body by going through the bloodstream. Just like other systemic treatments, the purpose of chemotherapy is to get rid of any cancer cells that may have spread from where the cancer started to another part of the body.
The body's normal cells grow and divide in a controlled manner. Cancer cells, however, grow and divide in seemingly total chaos --- without any control or logical order. Chemotherapy works by stopping the growth or multiplication of cancer cells, thereby killing them.
Specifically, Douglas and her team of researchers are looking at chemotherapy medicines called anthracyclines. These compounds are used to treat a variety of cancers, which includes leukemia, lymphomas, uterine, ovarian, and breast cancers. Anthracyclines are also known to have a weakening effect on some women's hearts.
According to Douglas, “There are other drugs that are less harmful, and we know a little bit about how to lower the doses”, but added that it's too soon to start completely overhauling breast cancer therapy. Instead, doctors and organizations including the National Breast Cancer Coalition are calling for more research into cancer treatments to see whether other drugs might yield the same result without the added long-term risk.
Douglas also stresses the importance of taking into consideration the different factors surrounding a woman's condition, as patients are “taking hits from multiple places.” While the cancer therapy might be one source of added cardiovascular risk, diet, weight, and family history also play a major role.
Still, she advises patients who learn they have breast cancer to consider treatment. “First get cured!” But she clearly emphasized to seriously take the consequences that dieting and regular exercise can have for your health while taking chemotherapy medications, something that is not necessarily heart healthy.
No matter how you look at it, cancer treatment remains to be a right combination of medicine and living a healthy lifestyle.
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