Medical guidelines and personal experience helped three-time survivor Susie Leigh recognize post-cancer heart issues.
The American College of Cardiology Foundation and American Heart Association Task Force on Practice Guidelines address the diagnosis and management of heart failure in adults. However, some patients with cancer may be predisposed to the development of heart failure because of cardiotoxic effects of certain types of chemotherapy and/or radiation therapy to the chest, but there are few specific monitoring recommendations.
Susie Leigh knows this and a lot more about being a cancer survivor. As an oncology nurse, she works with cancer patients in Tucson, Ariz., lectures around the country about survivorship issues and is a founding member and past president of the National Coalition for Cancer Survivorship. She has also survived three cancer diagnoses: Hodgkin lymphoma at age 24, breast cancer at 43 and bladder cancer at 47. Now 65, Leigh has carefully watched her health.
When the Children’s Oncology Group (COG) and the National Comprehensive Cancer Network (NCCN) both issued guidelines for adolescent and young adults that identified potential cardiac risk factors, including full chest radiation for Hodgkin lymphoma, she requested a baseline diagnostic test. An initial baseline echocardiogram, which uses sound waves to create a moving image of the heart, and electrocardiogram, which looks at the heart’s electrical signals, showing the rate and rhythm of a heartbeat, were considered normal.
Throughout 2012, Leigh’s shortness of breath and accompanying fatigue became progressively worse. While she generally attributed this to being out of shape, or possibly lung problems from her prior treatments, she returned to the Veteran Affairs Medical Center in early 2013 and just happened to see a former nurse practitioner who knew her cancer history. Blood work, chest X-ray, echocardiogram and pulse oximeter testing all pointed to heart problems. After a brief hospitalization, she learned her heart valves weren’t functioning correctly, leading to systolic heart failure.
In March, Leigh had a cardiac catheterization that resulted in stents placed to open two arteries. She will be following up in the coming months to see how well her heart recovers.
The American Heart Association lists a number of signs of heart failure. They are shortness of breath, persistent coughing or wheezing, build-up of excess fluid in body tissue, tiredness or fatigue, lack of appetite or nausea, confusion or impaired thinking and heart palpitations (where your heart feels like it is racing or throbbing). By themselves, any one sign of heart failure may not be cause for alarm. Survivors who have more than one of these symptoms, even if they haven’t received a diagnosis of any heart problems, should report them to a healthcare professional and ask for a cardiac evaluation.