Interview carried out with Professor Linda Worrall-Carter (Founder & CEO of Her Heart) and Professor Marion Eckert is the Inaugural Professor of Cancer Nursing in South Australia and the Inaugural Director, Rosemary Bryant AO Research Centre.
We have known each other for a few years now but I would love for you to share with our community a little more about you and why you are so passionate about Cancer nursing?
I am the Inaugural Professor of Cancer Nursing in South Australia and the Inaugural Director of the Rosemary Bryant AO Research Centre. I feel privileged to work in a field that is incredibly fulfilling and meaningful to me. For over 25 years, I have dedicated my career to improving the lives of patients with chronic disease and their families through research, education, and clinical practice. My passion for cancer nursing stems from my belief that every patient deserves the best possible care and support, no matter their diagnosis or prognosis. Cancer can be a devastating disease, and the physical, emotional, and psychological toll it takes on patients and their families can be immense. As a cancer nurse, I have had the opportunity to support and care for patients during some of the most difficult times of their lives, and it is a privilege to be able to make a positive difference in their journeys.
Through my work at the Rosemary Bryant AO Research Centre, I am able to lead and contribute to cutting-edge research that aims to improve patient outcomes and quality of life. Our research focuses on identifying and addressing the complex needs of cancer patients, from prevention, symptom management to survivorship care. I am proud of the work we have done to translate research into practical solutions that can be implemented by clinicians and patients alike.
What is cardio-oncology, and why is it important for cancer patients?
Cardio-oncology is a relatively new field that focuses on the intersection or connection between cancer treatment and cardiovascular health. Unfortunately, many cancer treatments, such as chemotherapy and radiation therapy, can cause damage to the heart and cardiovascular system. Cardio-oncology specialists work with oncologists and other healthcare providers to manage and prevent these potential heart problems, which can sometimes have serious implications for cancer patients and survivors. By monitoring and treating heart conditions in cancer patients, cardio-oncologists can help to improve both the quality and quantity of life for cancer survivors.
How can cancer treatments such as chemotherapy and radiation therapy affect the heart and cardiovascular system?
While it is obviously important to treat the cancer, it is known that chemotherapy drugs can have serious effects and be quite toxic to the heart muscle, it can sometimes affect the valves and/or cause damage to the heart’s pumping function. Radiation therapy can also damage the heart and blood vessels, leading to conditions such as coronary artery disease and potentially even heart failure. Both treatments can increase the risk of heart attacks and arrhythmias. In some cases, the effects on the heart may not show up until many years after treatment has ended, which is why it’s important “not to be alarmed but be aware”. Cardio-oncology specialists work with oncologists to identify potential heart problems early and manage them appropriately. If you know you have previously had a heart condition prior to your cancer treatment then it is particularly important to let your specialist know, as there can be the necessary follow up.
What are the key issues for women who have had cancer, particularly breast cancer, in terms of cardiovascular health?
Breast cancer is one of the most common types of cancer in women, and many breast cancer treatments (due to the location of radiation and also chemotherapy) can have long-term effects on the heart and cardiovascular system. Some of the key issues for women who have had breast cancer include an increased risk of developing heart disease, heart failure, and other cardiovascular problems. There are also some types of blood cancers that require extensive radiation and chemotherapy that can also have implications for heart health.
What are some risk factors for developing heart problems after cancer treatment, and how can they be managed?
Some examples of risk factors for developing heart problems post cancer treatment include a history of heart disease, high blood pressure, diabetes, and certain chemotherapy drugs. Cancer patients and survivors can manage these risks by working with their healthcare providers to monitor their heart health. Depending on your risk, this might involve undergoing cardiac testing such as echocardiograms (ultrasound of the heart) or a stress test, and making lifestyle changes such as quitting smoking or adopting a heart-healthy diet. In some cases, medications or other interventions may be necessary to manage cardiovascular risk factors, such as blood pressure medications or statins to lower cholesterol levels. If you have had cancer recently then its always important to speak to your specialist, and/or follow up with your GP.
If a woman has had cancer, then how can they monitor and maintain their cardiovascular health?
Women who have had cancer can monitor and maintain their cardiovascular health by keeping in touch with their specialist and/or GP healthcare provider to identify any potential risks for cardiovascular problems. We would also like to encourage women to be proactive, and should cardiac symptoms emerge that they approach their treating oncologist/radiologist to ask for a referral to a cardiologist. In terms of how women can maintain their heart health, they should be encouraged to stay active, eat a healthy diet, not smoke and avoid excessive alcohol consumption (in some cases they suggest zero alcohol). They might also be required undergo regular cardiac testing, such as echocardiograms or stress tests, to monitor for any changes in heart function or wear a holter monitor (24-48 hours) if there is a heart rhythm disturbance.
Are there any lifestyle changes or interventions that can help prevent or reduce the risk of heart problems in cancer survivors?
Yes, there are several lifestyle changes and interventions that can help prevent or reduce the risk of heart problems in cancer survivors. These include adopting a heart-healthy diet such as the Mediterranean Diet), staying physically active (such as walking every day or exercising at least 3 times a week for 30 minutes). If you smoke then get support to quit, there are many ways that you can receive help and it is never too late. In terms of alcohol consumption, there is more research about the benefits of abstaining from alcohol and while this can be challenging for some, there are increasingly alcohol free drinks available and community groups to get support from (such as hellosundaymorning.com). I would also suggest managing any stress that you might have, and look at ways to relax including meditation, yoga and or dancing – anything you might enjoy doing. In some cases, medications or other interventions may also be necessary to manage risk factors.