Protect your heart from effects of chemotherapy

Chemotherapy is a powerful tool in the fight against cancer; however, it can also affect your heart.

Oncologists are very aware of the possible side effects of treatments and work closely with patients to evaluate and monitor patients at risk. The good news is that we know much more about how to treat heart conditions than we did when some of these cancer drugs were introduced.

Understanding the risks and how to protect your heart during treatment is essential to staying healthy and completing your cancer care plan.

Can chemo cause heart problems?

While cancer itself doesn’t directly cause heart disease, several drugs used to treat some of the most common forms of cancer, like breast cancer, leukemia and lymphoma, can affect how the heart functions. Cardiotoxicity refers to any form of heart damage that may occur due to cancer treatment.

Effects of chemotherapy on the heart

Certain chemotherapy medications can weaken the heart muscle or disrupt its rhythm. While rare, this can result in:

• heart failure (reduced ability to pump blood)
• arrhythmia (irregular heartbeat)
• increased blood pressure
• damage to heart tissue
• heart palpitations
• heart attack

These side effects are more common in patients with pre-existing heart conditions or those receiving specific cancer drugs. Symptoms may not appear right away, and some patients with cardiotoxicity won’t experience symptoms at all. That’s why monitoring and prevention are key.

Signs of heart damage from chemo

While you should talk to your doctor about any concerns you have, the symptoms below may be a sign of your heart reacting to chemo medications:

• fatigue
• chest pain
• shortness of breath
• swelling in the ankles or legs
• rapid or irregular heartbeat

Keep in mind that early detection can prevent further damage so recognizing these symptoms and talking to your care team about them can result in a quicker treatment plan.

Cancer treatments known to cause heart damage

Two commonly used chemotherapy drugs are known for their impact on heart health:

• Adriamycin (doxorubicin): Used for breast cancer, leukemia, and lymphoma.
• Herceptin (trastuzumab): Used for HER2-positive breast cancer. When combined with Adriamycin, the lifelong risk of heart failure increases to 8–30%.

How to protect your heart during chemo

If you have a history of heart issues or any concerns about chemotherapy medications, talk to your doctor. There may be alternative treatment options. Doctors may also prescribe heart failure medications to protect the heart during treatment, especially for those who have already experienced some changes in their heart function or are known to be at higher risk for these side effects. That includes people over age 65 or those with a history of any kind of heart disease, including high blood pressure, coronary artery disease or heart rhythm problems.

We also treat people of any age who have the BRCA gene mutation. This is an inherited mutation that increases the risk of breast cancer. For some reason, people with the BRCA mutation are at increased risk for heart problems when treated with these drugs.

Can I reduce my risk of heart damage from chemo?

There are steps you can take toward protecting your heart:

• Talk to your oncologist about your heart health before starting treatment.
• Get a baseline heart evaluation if you have risk factors.
• Follow up regularly with your primary care provider.
• Report symptoms early to catch problems before they worsen.

Can I reverse heart damage from chemotherapy?

In some cases, yes. If heart damage is detected early, medications used to treat heart failure can help improve heart function. The key is early intervention and ongoing monitoring.

Even if you’ve completed treatment, continue to:

• attend follow-up appointments
• monitor your symptoms
• advocate for your heart health

It’s important to keep any heart side effects to a minimum so patients complete a full course of their recommended chemotherapy. That gives them a better chance for remission and ultimately curing their cancer.