Regular screenings can help protect your heart

Regular heart screenings can catch early signs of disease or damage for childhood cancer survivors.

Published: 12/1/14

Heart rate

Heart health can be affected by the treatments commonly used to cure many types of childhood cancer.  Most childhood cancer survivors who received potentially heart-toxic therapies have no heart damage. However, regular screenings for heart health (an echocardiogram – a test of heart muscle function) are crucial to catch problems at an early stage when they can be most successfully treated.  After learning that only about 20 percent of LTFU Study participants received their recommended heart screenings in the past five years, LTFU researchers looked for ways to encourage survivors to be screened.

Researchers studied 472 survivors 25 years old or older who had not received heart screening in the past five years. All participants received a detailed Survivorship Care Plan in the mail. A Survivorship Care Plan outlines a survivor’s cancer treatments and health risks and provides a recommended screening plan. Half of the participants also received two telephone counseling sessions with a nurse to discuss the obstacles to screening they experienced and encourage them to be screened. The research team found that survivors who received telephone counseling were twice as likely to complete their heart screening during the next year.

Additionally, screening detected early heart muscle disease (cardiomyopathy) or other heart problems in one out of five of the participants who were screened.

Survivors reported several obstacles to screening participation. You may have experienced some of these:

  • Not being aware of the importance of screening
  • Not having heart screening recommended to them by their doctor
  • Not being able to afford screening or being worried about insurance coverage or payment

The research team urged survivors to discuss their cancer history with their healthcare providers because informed providers may be better able to help their patients overcome obstacles to screening.  They also suggested that survivors ask their providers about the US Affordable Health Care Act (ACA). The ACA expands insurance access for people like cancer survivors who have pre-existing conditions. It also provides subsidies and help with copays for people with low and moderate incomes.

Treatments that can affect the heart include radiation to the chest, spine, abdomen, or total body, as well as the anthracycline chemotherapy drugs:

  • Doxorubicin (Adriamycin®)
  • Daunorubicin/daunomycin (Cerubidine®)
  • Idarubicin (Idamycin®)
  • Mitoxantrone (Novantrone®)
  • Epirubicin

If you received any of these treatments you should have a yearly check-up with special attention to any symptoms related to the heart. In addition, you should receive an electrocardiogram (ECG, EKG) about 2 years after you complete your cancer therapy). After that, an echocardiogram is recommended at regular intervals based on specifics of your cancer treatment.  If you received any potentially heart-toxic treatments, please talk to your doctor about screening for heart health and make it your priority to be screened.

Citations

Increasing cardiomyopathy screening in at-risk adult survivors of pediatric malignancies: a randomized controlled trial. Hudson MM, Leisenring W, Stratton KK, Tinner N, Steen BD, Ogg S, Barnes L, Oeffinger KC, Robison LL, Cox CL. J Clin Oncol. 2014 Dec 10;32(35):3974-81.