Heart Problems

Cancer treatments may sometimes result in damage to the heart. This is also known as “cardiac toxicity” or “cardiotoxicity”. Depending on the type of cancer treatment and damage, parts of the heart that can be affected include the normal cells around the heart, the heart muscles, heart lining and also vessels supplying blood to the heart. Although uncommon, these heart problems may cause discomfort that can lead to a negative impact on your quality of life, affect your ability to continue with the current cancer treatment, and in severe cases even be life-threatening.

Causes of heart problems in people with cancer

Chemotherapy (e.g. Doxorubicin, Epirubicin, Capecitabine)
Targeted therapy (e.g. Trastuzumab, Pertuzumab, Bevacizumab, Lapatinib, Sunitinib, Sorafenib, Ribociclib)
Radiation therapy to the chest area (e.g. for breast cancer, lung cancer, lymphoma)
Other conditions that are not cancer-related (e.g. hereditary, high blood pressure, high cholesterol, diabetes, stress, obesity, smoking)

What you need to look out for

Symptoms may develop during or soon after your cancer treatment, but it may also be unnoticeable until months or even years after treatment completion. However, you should seek medical attention once you experience any of the following symptoms:

Chest pain or tightness
Pain in the neck, jaw, throat, upper abdomen, arms or back
Fast or irregular heartbeat
Difficulty breathing
Coughing
Swelling of feet and lower legs
Feeling weak or dizzy
Feeling tired

How it can be treated

The risk of heart problems depends on the type and amount of cancer treatment you have. Before the start of your cancer treatment, your doctor will explain to you about possible side effects of the treatment. If there is a risk that your heart will be affected, investigations (usually a heart scan) may be done to assess your heart function before, during and after your treatment.

If heart problems are detected, your doctor may decide to reduce the amount of treatment, or change to another drug that may be less toxic to the heart. Your healthcare team may also refer you to a heart specialist for further tests and treatments that may improve your heart condition.

What you can do

The following are some tips you can do to keep your heart healthy during treatment:

Monitor and control high blood pressure, high cholesterol and diabetes. Continue to follow up with your general practitioner and take your regular prescribed medications

Exercise regularly, unless you are told not to do so

Use relaxation techniques such as deep breathing, gently shoulder and neck massages, meditation and visualization to help reduce stress levels

Eat a healthy and balanced diet consists of fruits, vegetables, whole grains, and low-fat dairy products
Reduce the amount of fatty meat, salt, sugar and saturated fat

Maintain a healthy weight. Excess weight may increase your risks of developing heart problems.

Stop smoking. Tell your family and close friends so that they can support you in your effort to quit smoking

Avoid excessive use of caffeine or alcohol

Avoid unnecessary stress at home or at work. Prioritise your outstanding tasks and start with more important ones first

When to call your cancer care team

Early treatment for cardiac toxicity may prevent serious heart damage. Therefore, please seek medical attention as soon as possible if you experience any of the following that may indicate heart problems:

Chest pain or tightness
Trouble breathing
Fainting or weakness
Swelling of feet and lower legs

If you have any questions regarding the above information, please call Cancer Helpline at +65 6225 5655 or approach your doctor or nurse for further details.

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The above contents are made available as part of TEMASEK FOUNDATION-ACCESS (Accessible Cancer Care to Enable Support for Survivors) PROGRAMME, a holistic care programme to support cancer patients during their care and recovery journey.

The contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers. However, this information serves only as a guide and should not be used as a substitute for medical diagnosis, treatment or advice. For specific medical conditions, please seek expert medical advice from your healthcare team.

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Heart Problems and Cancer