Older cancer survivors face a higher risk of stroke, heart attack and hospital treatment for heart failure, especially if they had chemotherapy, Monash University research study data has revealed.
Published in the journal CANCER, researchers investigated the effects of cancer treatment on older people and found the cancer and its treatment elevated the risk of cardiovascular events.
Monash University's Dr Suzanne Orchard and her team, including first author Jaidyn Muhandiramge, analysed data from the *ASPREE study and an embedded Cancer Treatment Substudy, which has followed adults aged 70 years and older living in the community in Australia and the US.
Participants were initially in good health and were followed over several years during which some experienced a new cancer diagnosis and/or a cardiovascular disease event.
Previous research has observed cardiovascular diseases, such as stroke and heart attacks, after cancer treatment, but this is the first time the effects of different types of cancer and treatment types has been analysed.
Of the 15,454 participants, 1,392 developed cancer over an average 4.6 years.
Rates for stroke, heart attack and hospital admission for heart failure were twice as high in those who developed cancer compared with those who didn't: 20.8 versus 10.3 events per 1,000 person-years. The elevated risk remained even after accounting for traditional cardiovascular disease risk factors.
Cardiovascular disease incidence following cancer diagnosis was greatest in patients with metastatic, blood and lung cancers. Chemotherapy was associated with twice the risk of cardiovascular disease events compared to other cancer therapies.
The results for other systemic therapies such as hormonal therapy, targeted therapy, immunotherapy and radiation therapy were inconclusive, although thoracic radiation is known to elevate risk. Aspirin did not impact cardiovascular disease incidence after cancer in this study.
Dr Orchard said as more people survived cancer, many faced long-term effects of the disease and its therapies. "The results underline how important early screening and prevention are in avoiding and minimising cardiovascular events after cancer diagnosis and treatment," she said.
"It's positive that more people are surviving cancer and living a long life. But it means we have a growing cohort of older people who could be at risk of health conditions related to the illness itself as well as from its treatment.
"This study adds to the growing body of data that shows those who have experienced cancer and cancer treatment face elevated risk of cardiovascular disease. While this is unwelcome news for cancer patients, the cardiovascular risk can be mitigated by early screening and preventative measures.
"More research is now needed to protect cancer survivors' cardiovascular and general health."
URL Upon Publication: http://doi.wiley.com/10.1002/cncr.35503
*About ASPREE ASPREE (ASPirin in Reducing Events in the Elderly) was a large primary prevention aspirin trial in more than 19,000 participants in Australia and the US, mostly aged 70 years and older, and continues today as a longitudinal study. Most ASPREE participants, who self-reported transport-related walking in the ALSOP (ASPREE Longitudinal Study of Older Persons) questionnaires sub-study, did so within 6-9 months of enrolment. The ASPREE project is funded by the National Institutes of Health (USA) and the NHMRC (Australia) and is led by Monash University in Australia and the Berman Center for Outcomes & Clinical Research in the US. Visit: https://aspree.org/aus/
