In light of American Heart Month, we feature the below research article on cardiovascular disease (CVD) mortality risk and cancer patients. There is an increased risk of CVD in cancer survivors related to mutual lifestyle and risk factors, cancer treatment, or “indirect results of cancer and its treatment (including cardio-respiratory deconditioning and weight gain)” [i].
Journal: European Heart Journal
In this observational study, over 3 million cancer survivors were compared to the general US population using the Surveillance, Epidemiology, and End Results (SEER) program from the years 1973 to 2012. As stated in the article, “the SEER program is a network of population-based incident tumour registries, covering 28% of the US population, including incidence, survival, and treatment.” The authors looked at CVD mortality risk in multiple cancer sites related to continuous calendar year, age at time of diagnosis, and follow-up time after diagnosis [ii].
The authors found:
1. Cancer patients (all cancer sites) are at an elevated risk of dying from CVDs compared to the general population
2. The majority of deaths from CVD occur in those diagnosed with breast, prostate, or bladder cancer
3. The first year after endometrial cancer diagnosis poses a very high risk of dying from CVDs
For the Patient and Caregiver
These findings highlight the importance of programs focused on CVD prevention in cancer patients. This month’s Today’s Dietitian Magazine’s article on Cancer and Cardiovascular Care discusses prevention programs, as well as lifestyle factors to target, including physical activity and eating pattern. In addition to the lifestyle factor intervention resources found on our website related to oncology, check out the cardiovascular resources from the National Lipid Association and the University Health Network at the Toronto Rehabilitation Institute.
For the Healthcare Team
In 2019, The American Heart Association proposed a cardio-oncology rehabilitation model, taking cardiac rehabilitation (focusing on exercise, nutrition, tobacco use, and risk factor assessment) and applying it to cancer survivors at the highest risk of CVD [Gilchrist SC, Barac A, Ades PA, et al, 2019 as cited in reference i]. In addition to this proposal, other cardio-oncology guidelines include those from the American Society of Clinical Oncology. Screening cancer survivors for CVD risk and supporting cardio-oncology rehabilitation programs are crucial foci for CVD prevention in cancer survivorship.
[i] Collins K. (2020). Cancer and cardiovascular care. Today’s Dietitian, 22(2):20.
[ii] Sturgeon KM, Deng L, Bluethmann SM, Zhou S, Trifiletti DM, Jiang C, Kelly SP, Zaorsky NG (2019). A population-based study of cardiovascular disease mortality risk in US cancer patients. European Heart Journal, 40(48):3889-3897. https://doi.org/10.1093/eurheartj/ehz766