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Most childhood cancer survivors do not experience heart problems as a result of their therapy. But certain treatments for childhood cancer may lead to heart disease later in life.
The heart is a muscular organ that pumps blood to the body’s organs. The heart is at the center of the circulatory system, which is made up of a network of blood vessels, such as arteries, veins, and capillaries.
An electrical system controls the heart and uses electrical signals to contract the heart's walls. When the walls contract, the heart pumps blood. Inlet and outlet valves in the heart chambers keep the blood flowing in the correct direction.
A healthy heart supplies the body with the right amount of blood at the rate needed to work well. If disease or injury weakens the heart, the organs won't get enough blood to work correctly.
Treatments including anthracycline medicines and chest radiation may lead to heart disease in childhood cancer survivors. Nearly 60 percent of all survivors of childhood cancer have had exposure to either anthracycline chemotherapy, chest radiation, or both.
The risk of developing congestive heart failure increases with the amount of medicine given (dosage):
|Anthracycline dosage (cumulative)
||Increased risk of congestive heart failure
|Less than 250 mg/m2
||Less than 5 percent
|Between 250 mg/m2 and 600 mg/m2
||About 10 percent
|More than 600 mg/m2
Radiation that includes the heart in the area of treatment increases the risk of developing certain heart conditions.
The risk increases with the amount of chest radiation given (dosage).
|35 Gy or more
|15 Gy-<35 Gy
Survivors who received both anthracyclines and chest radiation have the highest risk.
Heart disease runs in some families.
Women after menopause have an increased risk.
Other health conditions may increase the risk of heart problems:
Certain cancer treatments can increase the risk that survivors will develop these health conditions.
Cardiomyopathy can progress over time and lead to heart failure. Other heart conditions can also lead to heart failure. This condition means the heart can’t pump enough blood to meet the body’s needs.
Cardiovascular Risk Calculator
Cancer survivors can take steps to maintain heart health:
Some lifestyle habits increase the risk of heart disease. These include lack of physical exercise and an unhealthy diet.
Habits that lessen heart disease risk:
Exercise and eating a healthy diet can lessen the risk of developing these conditions. Everyone should lead a healthy lifestyle, but it is particularly important for cancer survivors who already have an increased risk of developing heart disease.
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Reviewed: June 2018