Nowadays the most common cancers have a survival of more than 50%.
However, after surviving their initial cancer, many patients are at high risk of premature disease or death, because they received one or more of the commonly used cancer therapies that are associated with higher risk of heart disease.
These risks are especially true in older cancer survivors who already have heart problems, and in adults who got cancer treatment in childhood and who have heart problems when they are young.
Currently, many cancer therapies, including radiotherapy, chemotherapy, and hormone therapy may be related to direct heart damage or help develop heart disease factors.
For example, people who receive breast cancer or prostate cancer therapy have higher risk of heart disease because the treatments lead to early menopause in women and lower levels of testosterone in men, which in turn cause belly fat and metabolic syndrome.
Some common chemotherapies for leukemia, breast cancer, lung cancer, and ovary cancer can have heart problems side effects and the effects may be undetected for years because they are subclinical.
Other therapies are associated to risk of heart failure and may be hard to detect early.
Radiotherapy to the chest, which is common in breast cancer treatment, may have both short-term and long-term heart damage effects, especially if it is administered with simultaneous chemotherapy.
The risk may be lowered with cardiac shielding, breath-hold techniques and planning computed tomography (CT) scans.
But women with left-sided breast cancer may be at particular risk, especially as the possibility of heart disease may be under-estimated by health professionals and by women themselves.
In addition, cancer patients may not receive the monitoring and interventions needed to reduce their risk of heart disease.
Currently, follow-up care after treatment for cancer largely focuses on monitoring for cancer recurrence, not heart disease. And only a minority of GPs often consider a history of cancer treatment as heart disease risk factors.
It is important that GPs learn more about how primary care could improve cardiovascular outcomes in people living with and beyond cancer and receive further education on the effects of cancer treatment on cardiovascular health.
Additionally, a complementary self-help guide should be available to help people with cancer keep their hearts healthy during their treatment and in the years ahead.