how to help the heart during chemotherapy for breast cancer
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by amy kirkham, r.e. shave, k.a. bland, j.m. bovard, n.d. eves, k.a. gelmon, d.c. mckenzie, s.a. virani, e.j. stöhr, d.e.r. warburton, and k.l. campbell
as if breast cancer patients didn’t have enough to worry about, the chemotherapy that can kill their cancer can also create problems for their hearts. chemotherapy can cause irregular heart beats, or arrhythmia, which can damage the muscle and prevent it from properly pumping blood.
early studies on rodents suggest that one session on a treadmill 24 hours before chemotherapy treatment with drugs called anthracyclines, including the commonly used drug doxorubicin, can actually protect the heart from the most damaging effects of chemotherapy. the researchers wanted to study this to see if this was also the case in human patients.
what they did and what they found
twenty-four pregnant individuals in the early stages of breast cancer were asked either to walk vigorously for 30 minutes on a treadmill 24 hours before their first chemotherapy treatment (while supervised), or they were asked not to exercise vigorously 72 hours before treatment. the researchers took blood samples and a heart ultrasound before the first chemotherapy treatment and 24 to 48 hours after the first treatment ended.
the patients who performed the exercise sessions appeared to have less stress on their hearts, which was shown by lowered amounts of nt or probnp (substances produced by the heart). higher levels of these after the first chemotherapy treatment often means that the heart will be injured in the future. the group that exercised also had a small increase in the heart’s ability to contract (systolic function,; or the pumping of blood in the heart).
these early findings suggest that intense aerobic exercise may be an easy way to reduce the negative effects of chemotherapy on the heart. before this can be stated as fact, it needs to be studied more to determine whether exercising before every chemotherapy treatment can be recommended.
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the bottom line
cancer patients who need chemotherapy might be able to reduce the effects of the drug doxorubicin on their heart by exercising 24 hours before their treatments. the study showed that vigorous exercise significantly lessened nt-probnp, which can predict cardiac events. in fact, exercise cut the risk of reaching levels of nt-probnp associated with heart failure by almost half.
exercising is an easy and practical way of possibly reducing the bad effects of doxorubicin chemotherapy treatment on the heart, especially if exercising is done throughout all of the treatments. whether cancer patients need to exercise vigorously before each chemotherapy treatment remains to be studied.
this summary summarizes the study amy kirkham, r.e. shave, k.a. bland, j.m. bovard, n.d. eves, k.a. gelmon, d.c. mckenzie, s.a. virani, e.j. stöhr, d.e.r. warburton, k.l. campbell protective effects of acute exercise prior to doxorubicin on cardiac function of breast cancer patients: a proof-of-concept rct is published in the international journal of cardiology, 10.1016/j.ijcard.2017.07.037.
this summary was written for the canadian society for exercise physiology and has been reviewed by the csep knowledge translation committee.
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