February 12, 2025

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Information treatments and health conditions

Here’s how you can prioritize your heart health during, after cancer treatment

Here’s how you can prioritize your heart health during, after cancer treatment

This story first appeared in Healthy You – January 2025, The Gazette’s quarterly health publication.

In 2022, there were 18.1 million cancer survivors in the United States, according to cancer.gov. By 2032, there will be an estimated 22.5 million.

This good news for cancer patients has presented a new challenge for healthcare providers: ensuring a good quality of life during and after undergoing physically challenging cancer treatments. Cancer patients and survivors who’ve also been diagnosed with heart disease face particular challenges.

Most people have heard of the side effects of cancer treatments: nausea, hair loss, anemia and fatigue. Those side effects are usually temporary, abating after completing radiation, chemotherapy or immunotherapy treatments.

Cancer treatments can also have longer-lasting side effects, including damage to the heart, that might not show up until years later. Cancer treatments can also exacerbate existing cardiovascular problems for patients at risk for heart disease.

Because heart disease is so widespread in the United States — it’s the leading cause of death for men, women, and most ethnic groups — many cancer patients need to consider their heart health as they undergo cancer treatment.

In response to research on the effects of cancer and cancer treatment on the heart and cardiovascular system, Mercy Medical Center in Cedar Rapids has established a Cardio-Oncology program at the Hall-Perrine Cancer Center. This new program provides a collaborative approach to cancer treatment needs. In addition to receiving cancer therapy, heart specialists and oncologists evaluate the patient’s risk of heart complications and treat any heart conditions before, during and after cancer treatments.

According to Dr. Cam Campbell, cardiologist and co-medical director of the cardio-oncology program at Mercy’s Hall Perrine Cancer Center, researchers and medical professionals discovered a link between cancer treatments and heart complications in the late 20th century.

“Cancer survivors who’d had chemotherapy for childhood cancers developed heart failure in their 40s,” Campbell said.

As more research showed connections between cancer and heart disease, Campbell worked with Mercy to establish a cardio-oncology program.

Any patient receiving treatment at Mercy’s Hall-Perrine Cancer Center can be seen by cardio-oncology specialists like Campbell before beginning cancer treatment. According to Campbell, “ninety percent of our referrals come from the medical oncologists,” the cancer specialists who determine treatments and care for cancer patients. “They will know who’s at risk because they’ve seen patients’ charts,” he said.

Patients with heart disease might present with a wide variety of conditions: coronary or valve disease, thickened or weakened heart muscles from a prior heart attack, or issues with the electrical impulses that cause the heart to work. A cardio-oncologist can determine how best to proceed with cancer treatment given these risk factors

Usually, the first step Campbell will take with at-risk patients is to give an echocardiogram to determine the condition of the patient’s heart.

“We have an echocardiogram machine right here in the cancer center,” Campbell said.

Dr. Cam Campbell, cardiologist and co-medical director of the cardio-oncology program at Mercy’s Hall Perrine Cancer Center. (Submitted photo)

Dr. Cam Campbell, cardiologist and co-medical director of the cardio-oncology program at Mercy’s Hall Perrine Cancer Center. (Submitted photo)

With echocardiogram results and information from patients’ files, Campbell then consults with the medical and surgical oncologists. Collaboration is seamless.

“I walk up the stairs and into their office to talk with them,” said Campbell, whose office isn’t in the cardiology wing, but right in the Cancer Center. “I might say, ‘this patient has a pacemaker, how do we get around it.’ The goal is to provide the best cancer care possible with the fewest cardiac side effects.”

Even with coordination of care, cancer treatments can be hard on the body. Early treatments blasted the cancer with large amounts of chemotherapy and radiation, which could cause severe side effects and, occasionally, organ damage. Even today’s more advanced targeted therapies, like HER2-targeted treatments and immunotherapy, can affect the function of the heart.

“Each type of treatment has certain side effects: colitis, myocarditis, thyroiditis,” Campbell said. “We can warn the oncologist about these side effects and coordinate care between the medical oncologist and the surgical oncologist.” Sometimes additional medications for heart patients with cancer are prescribed, and in every case, the patient’s cardiac health is carefully watched.

The cardio-oncology program also works closely with other programs at the Hall-Perrine Center to care for cancer patients with heart issues. Because cancer and cancer treatment can take a toll on the cardio-vascular system, the Hall-Perrine Cancer Center offers the Thrive Oncology Fitness program to help patients develop stamina and strength, including cardiovascular fitness. Cancer treatments can be detrimental to overall fitness, including cardiovascular fitness.

According to Campbell, one study showed that a fit and active 50-year-old woman undergoing cancer treatment has similar fitness results to a 60-year-old sedentary woman. Building up strength before and during treatment can be especially important for people at risk for — or with — heart disease.

Sometimes side effects occur years after cancer treatments, which is why the cardio-oncology program offers care before, during and after cancer treatment.

“Between the stress of the chemo and inflammatory processes going on in the body during treatment, you can be more likely to develop blocked arteries,” Campbell said. The blocked arteries might show up during treatment, or in the months or years afterwards.

This is what happened to Bridget Humphreys, of Cedar Rapids, who was treated for Hodgkin’s lymphoma 20 years ago. Recently, she had a blockage near her clavicle. Her symptoms were puzzling to her.

“ I couldn’t lift my arm,” Humphreys said. “When I was hanging up clothes, my arm felt weak.”

Although it had been years since her cancer treatment — which had also been in a different state — Campbell was still seeing her for post-cancer checkups.

Humphreys didn’t hesitate to call Campbell’s office. “They never give me the brush-off,” she said. “And Dr. Campbell is so good at explaining things. He takes time to talk with me.”

Campbell determined that the problem was an arterial blockage, likely caused by cancer treatments many years ago. The blockage was removed with balloon angioplasty, and Humphreys avoided a more serious situation.

“He was really keeping an eye on that,” Humphreys said. “It’s nice to know that they’re on top of everything.”


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