Search
Heart Screening After Childhood Cancer: Do You Need It?
Some childhood cancer treatments can affect how the heart works even years after treatment has ended. These are called late effects.
Treatments that can increase the risk of heart problems include:
- High doses of anthracycline chemotherapy medicines such as doxorubicin, daunorubicin, mitoxantrone, epirubicin, and idarubicin
- High doses of chest radiation
How childhood cancer treatments affect the heart
These treatments can increase the risk of heart problems later in life, including:
- Heart muscle weakness (cardiomyopathy)
- Heart rhythm problems
- Heart valve disease
Heart screening guidelines for survivors
Work with your health care provider to learn your heart health risks.
The main screening test for heart problems such as cardiomyopathy is an echocardiogram (echo test). It uses sound waves to show how well your heart works and pumps blood.
Research shows that some survivors have a low risk of heart problems. Because of this, routine heart screening is no longer recommended for low-risk survivors.
This change may affect survivors who had:
Lower doses of anthracycline chemotherapy
- No or very low doses of chest radiation
Next steps: How to check your heart risk
Check your survivorship care plan to learn whether you received anthracycline chemotherapy and/or chest radiation. The plan includes your treatment history and recommended follow-up care.
If you do not have these records, contact your treatment center or use a tool like Passport for Care. It is a free online tool that helps you generate a survivorship care plan from your treatment summary.
Ask your health care provider about your heart risk and whether you need heart screening. Bring your survivorship care plan to health care visits.
Getting an echocardiogram
During an echocardiogram, gel is placed on the chest and a wand is used over the skin to captures images needed to see how your heart is working. The test is usually done while awake, is painless, and does not expose you to radiation. An echo takes about 30-60 minutes to complete.
If you need help scheduling an echo, start by contacting the treatment center where you received cancer care.
Many survivorship programs can help you find a place to get an echo. They may also know about lower-cost options near you.
Bring a copy of your survivorship care plan to your appointments. It tells your health care provider about your cancer treatment and the follow-up care you need.
Paying for heart screening
The cost of an echo depends on where you live, where you have the test done, and your health insurance. It can range from a few hundred to a few thousand dollars.
Many health insurance plans cover echo tests when a health care provider says it is needed. For childhood cancer survivors at high risk for heart problems, your insurance may cover the test. How much you pay depends on your insurance plan.
Lori Douglas
If you have questions about your insurance coverage for an echo test, contact your insurance company. Ask if your plan has a case manager. A case manager can answer questions, help arrange care, and help you get the services you need.
If you do not have insurance or need help paying for a test, talk to a social worker at your treatment center. Many hospitals and imaging centers offer help with costs and payment plans. Your survivorship clinic may also know about lower-cost places to get an echo test.
"When survivors get billed for an echo, the cost can be alarming,” says Lori Douglas, clinical nurse coordinator of the Long-Term Follow-Up Clinic, Texas Children’s Hospital. “If the cost is too high, reach out to your survivorship clinic or your local health care provider. We may be able to help you find a lower-cost option.”