New Delhi: The connection between heart disease and cancer has been the subject of scientific investigation for decades; however, emerging evidence suggests an alarming association between cardiovascular disease and the occurrence of aggressive breast cancer. With the increasing prevalence of heart disease worldwide, scientists are discovering complex crossroads between cardiovascular disease and cancer risk, particularly in patients with established cardiovascular disease. From a drug development point of view, these new findings are challenging and offer opportunities for clinicians, necessitating a multi-disciplinary treatment strategy and a more integrated approach to manage the long-term care of such patients.
How does heart disease affect cancer risk?
“Heart disease, such as coronary artery disease, heart failure, and hypertension, has been a chronic cause of morbidity and mortality globally. Conversely, breast cancer is one of the most prevalent cancers in women, with the risk of metastasis and recurrence in advanced disease. Emerging evidence has raised alarms that patients with cardiovascular disease, especially those who have undergone specific cardiovascular interventions, are at increased risk of developing more aggressive forms of breast cancer,” Dr Aravind Badiger Technical Director of BDR Pharmaceuticals said.
A key factor linking heart disease and advanced breast cancer is the common molecular pathways involved in the two conditions. Heart disease and cancer share features of chronic inflammation pivotal in the two conditions. For heart disease, inflammation leads to the development of atherosclerotic plaques and vascular injury. Conversely, for breast cancer, inflammatory responses can promote tumor growth, metastasis, and drug resistance. For instance, high levels of inflammatory cytokines like IL-6 and TNF-alpha, involved in cardiovascular disease and cancer, may pose a risk of tumor growth in breast cancer patients. Chronic inflammation may also compromise the immune system and thus the body’s capacity to clear tumor cells effectively.
Certain therapies used in the management of heart disease also inadvertently increase the risk of advanced breast cancer. For instance, some of the drugs used in the management of cardiovascular disease, especially in heart failure or hypertension patients, have the potential to interfere with hormonal pathways pivotal in the development of some forms of breast cancer. Drugs like beta-blockers and ACE inhibitors have the potential to modulate estrogen signaling and other hormone-dependent pathways pivotal in the development of estrogen receptor-positive breast cancers. While such drugs are essential in the management of heart disease, their use over long periods may interfere with mechanisms that regulate breast cancer development, especially in those with a genetic predisposition.
Chemotherapies and radiation therapies applied in the management of breast cancer have important consequences for cardiovascular well-being, particularly in patients who have pre-existing cardiovascular disease. Anthracyclines, a group of chemotherapy agents, are recognized to induce cardiotoxicity, resulting in heart failure and other forms of cardiac impairment. In heart disease-predisposed patients, the administration of these therapies provokes important considerations regarding the trade-off between the successful treatment of cancer and cardiovascular function preservation. Thus, such patients’ drug management must have a fine balance between cancer therapy and heart protection.
Pharmacologic interventions for patients with simultaneous heart disease and breast cancer must be carefully devised to meet these special challenges. From a cardiology point of view, attentive monitoring of cardiovascular function is critical in patients receiving cancer treatment, especially in those treated with chemotherapy that predisposes to worsening heart disease. Moreover, novel advances in targeted therapies and immunotherapies for breast cancer may provide new avenues for treating cancer in heart disease-predisposed patients. Agents such as trastuzumab (Herceptin) and immune checkpoint inhibitors have transformed the treatment of breast cancer, providing more personalized and potent treatments. These therapies are tailored to specifically target cancer cells with minimal harm to surrounding healthy tissues, providing a potentially safer choice for patients with compromised cardiovascular well-being.
Parallel to this is growing discussion among the pharmaceutical community regarding the creation of new therapies that can treat cardiovascular risk as well as cancer progression at the same time. For example, anti-inflammatory drugs or anti-inflammatory agents can decrease the inflammatory load of cardiovascular disease and cancer. The use of statins, traditionally used in cardiovascular disease, is another factor of relevance. Statins not only lower cholesterol but also have anti-inflammatory properties; some data have suggested that they can reduce the recurrence risk of breast cancer, especially in individuals with high inflammatory markers.
Preventive medicine forms a crucial part of the treatment of the dual risk of cardiovascular disease and breast cancer. Given the common risk factors inherent to both diseases, such as obesity, smoking, and physical inactivity, there is a need to modulate lifestyle determinants through behavioral changes and pharmacologic interventions. Drugs that control weight, drugs that control smoking, and drugs that control diabetes may have a crucial role to play in the prevention of risks for both cardiovascular disease and advanced breast cancer. Specifically, drugs that reduce weight such as GLP-1 agonists and bariatric surgery may improve metabolic health reduce the inflammatory burden, and thereby help prevent the development or progression of both diseases.
In summary, the interaction of heart disease with advanced breast cancer risk is increasingly a cause for concern for practitioners. From the pharmaceutical industry perspective, the treatment of patients with both conditions must be holistic and patient-specific. The involvement of inflammation, hormonal pathways, and cardiovascular therapies must be evaluated in developing therapeutic interventions for such patients. Advances in targeted drugs, immunotherapy, and integrative treatment modalities have bright prospects, yet more research is needed to understand the mechanisms of action and determine the best treatment protocols. Through interdisciplinary collaboration and continued drug care advances, it is possible to improve outcomes for patients with the dual burden of heart disease and breast cancer.
Patients of heart disease are vulnerable to early death risk, but little did one know that it could also result in breast cancer. Here’s what you need to know. Health Conditions Health News: Latest News from Health Care, Mental Health, Weight Loss, Disease, Nutrition, Healthcare
