With advances in the treatment of breast cancer, many women are living longer and longer into survivorship. This is great news, however many of these women are living with long term effects of their cancer treatment. One of these effects is cardiotoxicity or damage to the heart, and it can be one of the most devastating. It is possible that a patient may survive breast cancer only to develop heart failure, which has a higher mortality rate than cancer.
During breast cancer treatment, many of the common chemotherapy and targeted agents used have known cardiotoxic effects – damaging heart muscle cells. Radiation therapy, if close to the heart, can cause this damage as well. Over time, the heart muscle becomes weaker, and less capable of pumping blood through the body and so heart failure can occur even years after treatment.
Conventional treatment aims to minimize the damage as much as possible, however there are some lifestyle interventions as well as natural therapies that can help.
Firstly, it is important to know up front if your treatment has the potential to injure your heart. If that’s the case, your oncology team will ask for heart tests before treatment as it is necessary to know baseline heart function. After a potential cardiotoxic treatment, your heart function will be checked periodically and so it’s important to keep track of any signs or symptoms of reduced heart function, which include shortness of breath during daily activities, heart palpitations, fatigue and swelling of the feet or legs.
Secondly, exercise during treatment is key in helping to protect the heart as well as improving function post treatment. Remember, your heart is a muscle, and so like any other muscle, it needs exercise. Exercise is known to protect the cardiovascular system in healthy populations and so it makes sense that for people with cancer, being physically active during treatment is a promising step in preventing the negative impact of cardiotoxic cancer treatment. Aerobic exercise, where your heart rate is elevated for a continual stretch of time, has been shown to have a protective effect against treatment-induced cardiotoxicity. People undergoing treatment for cancer will have varying levels of physical ability as well as energy and so a good place to start is to aim for 30 minutes a day of an elevated heart rate, which can be divided in time. Walking is the perfect exercise to achieve this however if you are unstable and need assistance, consider getting an oncology rehabilitation assessment to go over individual needs. After treatment, keep the exercise going! Not only can exercise be important in reducing future risk of heart disease, but it also reduces your risk of breast cancer recurrence.
In terms of food, the Mediterranean diet has numerous positive heart-health effects. This can be a delicious way to both support your heart as well as reduce your overall risk for cancer. Read more details about the Mediterranean diet.
Avoid any further injury to your heart by avoiding tobacco and achieving a healthy body composition.
Lastly, a few natural supplements can support heart function. It’s best to speak with a licensed naturopathic doctor if you are undergoing cancer treatment, as safety is critical when combining conventional therapy with natural support. Coenzyme Q10 has been studied in congestive heart failure and can reduce symptoms. The herb hawthorn (Crataegus spp.) can be taken as a tea and studies support its use in reducing heart failure as well. Your naturopathic doctor can speak about forms of these supports as well as dosing.