Matters of the heart: How cancer and cancer treatment can affect your heart health

By Jessica Saenz

Cancer can form anywhere in the body, including the heart. While heart cancer, also known as a malignant primary cardiac tumor, is rare, the relationship between cancer and cardiovascular health is strong ― and complicated.

If you are undergoing treatment for cancer or you are a cancer survivor, it's important to understand how cancer treatment can affect your heart and what you can do to reduce your risk of cardiovascular conditions. Here's what you need to know about the connection between cancer and heart health:

Cardio-oncology can help manage heart disease risk

As cancer treatment and survival rates have improved over the past few decades, cancer and heart experts saw the need for more collaboration. Cardio-oncology, which addresses heart health before, during and after cancer diagnosis and treatment, was born out of this need.

"The emergence of cardio-oncology as a distinct practice ensures that we look at patients broadly from the perspective of their cardiovascular health, including disease- and treatment-associated risks, not simply as cancer patients," says Donald Northfelt, M.D., a Mayo Clinic hematologist and oncologist.

Experts in cardiology and oncology work together to determine a person's risk factors and provide a care plan that reduces the risk of developing heart conditions because of cancer or its treatment.

If you have been diagnosed with cancer and have a preexisting heart condition, cancer experts might refer you to their cardiology colleagues to develop a safe, effective care plan. Care and monitoring to reduce your risk of heart complications might be needed throughout your life.

Cancer, heart disease share risk factors

If you compare lists of cancer and heart disease risk factors, you'll notice many similarities. It's no surprise that many patients with cancer also have underlying heart disease.

"We know that cancer and cardiovascular disease share common risk factors. In fact, 20% to 30% of cancer survivors have underlying cardiovascular disease. They are 30% more likely to develop coronary artery disease and twice as likely to develop heart failure," says Adam Shultz, a clinical exercise physiologist. Smoking, obesity, age and poor diet are just a few of the major risk factors shared by both diseases.

"If you're a smoker, immediately stop. Know your cholesterol and blood pressure, modify your eating habits to ensure that you're eating a heart-healthy diet and ensure that you're getting plenty of exercise," says Jordan Ray, M.D., a Mayo Clinic cardiologist. Understanding these risk factors and discussing a plan with your health care professional is not only important for your diagnosis, but also it can improve your overall health and give you the tools to take control of your risk factors.

Some cancer treatments can affect your heart

Cardiovascular toxicity, or damage to the heart from cancer treatment, is an area that experts continue to study. Cancer experts first became aware of the heart-related side effects of cancer drugs in the 1970s. This awareness has continued to increase as more treatments for cancer have become available.

"Our colleagues in the oncology and hematology world have done a fantastic job of treating malignancies so patients are surviving for long periods of time," says Dr. Ray. "Because of that phenomenon, we're now recognizing cardiovascular disease as a consequence of the chemotherapy and radiation therapies they received during a malignancy."

Certain types of cancer and their treatment are more likely to result in cardiovascular side effects. Breast cancer radiation and drug therapy treatments, for example, might cause side effects to the heart, while pancreatic cancer as a disease is associated with heart disease risk.

Some risks can't be avoided. But you and your cardio-oncology team can work together to weigh the options and risks of each care decision and proceed with a plan that is safe and comfortable for you.

"We must weigh the benefit to the patient with the risk of harm from the treatment and involve the patient in that conversation. In the meantime, we're investigating ways to protect the heart while allowing protective cancer care to occur," says Dr. Northfelt.

Cardio-oncology rehabilitation can help you get your heart in shape

Exercise and movement are an important part of recovery for all cancer patients, especially those at risk for heart conditions, and physical activity benefits every leg of your cancer journey.

A rehabilitation program before cancer treatment might focus on improving your heart health through exercise, nutrition and healthy weight loss, while a plan during and after treatment might focus on helping you exercise safely. Supervision and guidance from cardio-oncology rehab specialists can ensure that you are improving based on your specific needs and within any temporary limitations.

"In cardio-oncology rehab, we work with patients who have either developed cardiovascular damage as a result of the treatment they have received, or those who are at an elevated risk of such damage because of their treatments," says Shultz.

Heart and lung experts work together to come up with a safe rehabilitation plan to help them get back in motion, but also learn how they can continue to maintain healthy habits after your treatment is complete.

"Only about 10% of patients going through treatments actually exercise regularly. And after treatments, only 20% to 30% are active. I congratulate them on coming to see us because they're a step ahead of the game," says Shultz.


The relationship between cancer and heart health is an important example of the many ways cancer can affect other aspects of your health. "Having a diagnosis of cancer is a monumental event, and it's very easy to get caught in that moment because cancer is a very scary situation," says Dr. Ray. But it's important not to neglect other areas of your health, especially because your daily habits significantly affect your risk of cancer and other diseases.

Healthy lifestyle changes — big and small — can contribute to better heart health and decreased cancer risk. While a cancer diagnosis is an important time to holistically evaluate the areas of your health that need improvement, it's never a bad time to check in with your heart. Why not start now?

Learn more

Learn about the Cardio-Oncology Clinic at Mayo Clinic.

Watch Dr. Ray discuss heart health for patients with cancer in this "Mayo Clinic Minute" video:

Watch Adam Shultz discuss cardiovascular rehabilitation for patients with cancer in this "Mayo Clinic Q&A" podcast" video: