August 09, 2018
为什么中,后管理心脏健康癌症治疗是关键
由Nicolas Palaskas,医学博士
每年,癌症幸存者数量的增长。这就是为什么它变得越来越重要了医生,以确保癌症治疗don’t cause any lingeringside effects— particularly when it comes to心脏健康。
心problems are the leading cause of death in Americans each year. Cancer is No. 2. So if we’re able to cure someone’s cancer, we certainly don’t want to leave them with any cardiovascular issues.
Chemotherapy drug adversely affects heart function
Many cancer treatments can impair heart function. One is the化疗drug doxorubicin, which is used frequently to treat乳腺癌,以及一些肉瘤和lymphomas。
自1970年代以来阿霉素已经出现,并且可以减少心脏的能力泵血。传统上,这种副作用已被描述为“不可逆”。但我们发现,有些病人我们给予保护心脏的药物,以改善显示,他们已经完成了治疗甚至几年后。所以,这是个好消息。
And, only about 2% of breast cancer patients will experience heart-related side effects from receiving the typical dose of doxorubicin. That goes up to about 5% in lymphoma and sarcoma patients, because of the higher doses used to treat those cancers.
Other treatments that affect heart function
可产生负面影响心脏另一种药物是曲妥珠单抗,这是一种类型的靶向治疗。它的影响已被经典描述为“可逆的。”这意味着,如果我们停止施用药物,副作用消失,心脏通常大约四个星期内恢复正常。但即使有新的靶向治疗,我们看到的患者不足1%的下降,心脏功能相关的副作用。
放射治疗也被证明会导致心脏堵塞或阀门的问题,所以患者被辐射处理,胸部一定要密切关注。MD安德森有一些最好的放射肿瘤学家的四周,他们是在通过聚焦辐射限制心脏损伤专家梁尽可能癌症本身上,而不是周围的组织。但心脏是如此接近某些器官,它仍然会受到影响。
Why getting a heart health baseline is so important
We don’t ever want to stop a patient’s cancer treatment prematurely. That’s why it’s critical for us to evaluate and test a patient’s heart function prior to starting any potential cardiotoxic treatment. This way, we can better recognize subtle signs of heart dysfunction as they occur and address them immediately.
我们也想继续看下去的患者他们已经完成治疗后,也因为副作用仍然可以显示5,10,15年甚至20年后的道路。
Managing other risk factors
请记住,心脏损伤癌症治疗所产生仍然是相当罕见的。事实上,我的心脏病患者中只有约5%的癌症有关的治疗心脏问题。其余的人的心脏问题的治疗之前,或以后开发的完全不相关的心脏问题。
有很多的其他危险因素,可能损害心脏,太 - 如高血压,糖尿病和高胆固醇。这就是为什么我倾向于寻找的问题,如阻塞的动脉或心脏发作比较常见的原因,并首先排除那些出来。
心脏衰竭的症状,寻找
At MD Anderson, our cardiologists use ultrasounds, EKGs and other tests to monitor heart function. But there are some signs of heart failure or blockages that patients can look for. These include:
- Chest pain or pressure, especially when you’re exerting yourself, such as taking the stairs or gardening
- Feeling more out of breath than usual (e.g., noticing you have to take a break and rest, even while grocery shopping)
- 腿部肿胀(例如,你的袜子让双脚缺口,它可以在生理信号的液体积聚,因为心脏没有充分抽)
- 以一定的角度睡觉(因为你呼吸短,当你在床上平躺)
我们告诉患者,就立即打电话,如果他们开始看到这些症状。当他们这样做,我们进行超声和/或其他测试,以确定它是否是他们的心脏。通常情况下,这些症状可能与利尿剂,它帮助身体棚多余的液体,和其他心脏药物进行管理。
患者有什么可以做,以保护自己的心脏健康
To minimize the risk of heart damage from cancer treatments, we recommend that you:
- Stay active. The American Institute for Cancer Research and the American College of Sports Medicine recommend 150 minutes of moderate physical activity or 75 minutes of vigorous exercise each week. Maintain your ability to climb a flight of stairs or swim laps in a pool.
- Maintain a healthy weight. If you’re overweight, losing just 5-10% of your body weight has huge health benefits.
- 按照地中海风格或大部分植物为基础的饮食是糖业有限公司。
请记住,大多数患者都不太可能发展造成的癌症治疗心脏问题,但所有的这些事情将竭诚为您服务好,如果你这样做。
萨科Palaskas,医学博士, is a cardiologist at MD Anderson. Dr. Palaskas will be sharing more insight on cardiac monitoring during and after treatment at this year’smyCancerConnection Cancer Survivorship Conference。注册参加9月13日和14。
在申请预约MD Anderson线上or by calling 1-877-632-6789.
心damage stemming from cancer treatment is still pretty rare.
萨科Palaskas,医学博士
医师