How to strengthen and protect the heart during chemotherapy? Constant exercise? Rest? Targeted diet?

Dear Reader,

not knowing his particular condition, we can give general indications, remembering, however, that it is always advisable to consult the family doctor and avoid the do-it-yourself.

First of all, it is important to remember that cardiovascular diseases and neoplasms often share the same risk factors: smoking, unhealthy diet, sedentary lifestyle. In fact, in the genesis of these pathologies, in addition to relatively rare genetic and familial causes, which generally cannot be modified, exogenous factors of an environmental nature come into play, such as exposure to toxic substances, metabolic and behavioral factors which can be modified. By now we know that the adoption of a “healthy” lifestyle is essential in the prevention of tumors and also their progression.

In general, constant and regular aerobic exercise 3-4 times a week for a minimum duration of 60 minutes per session is among the most effective and effective preventive methods for cardiovascular disease. It is important not to smoke and to avoid the consumption of alcohol, to maintain a regular diet, especially during cancer treatment, and a stable body weight through a balanced diet, rich in whole grains, vegetables, fruit, legumes and low in red meat and drinks sugary. “Alternative” diets based on food supplements are not recommended – and can indeed be potentially harmful.

In addition to measures to promote cardiovascular health through physical activity and a correct lifestyle, specialists will have to take care of the prevention and treatment of cardiovascular complications during oncological therapies. If it is true, in fact, that the importance of preventive measures in the fight against oncological pathologies is universally recognized, the continuous progress in the knowledge of the biology of tumors has made it possible to have increasingly effective and targeted drugs. However, some of these substances can cause cardiotoxic effects. Cardiac dysfunction may present asymptomatic (with changes in cardiac biomarkers) or symptomatic (with signs of heart failure). Other drug side effects include myocarditis, myocardial ischemia, arterial hypertension, and various types of arrhythmias.

The phenomenon has been studied in recent years by Cardio-Oncology, the specialty that deals with the diagnosis, prevention and treatment of cardiovascular complications during anticancer therapy. For cancer patients candidates for chemotherapy treatment, therefore, the close and synergistic collaboration between oncologist and cardiologist assumes vital importance. This work in a multidisciplinary team makes it possible to identify people who are not cardiopathic but at risk of developing cardiotoxicity, such as diabetics, obese, dyslipidemics, smokers, alcohol consumers. Always together, these specialists can define comorbidity control programmes. For heart patients, on the other hand, they pay attention to therapeutic optimization and implement close monitoring. For cardiac patients who have to undergo oncological surgery, they will arrange a preventive pre-operative cardiological evaluation, to avoid the risk of post-operative cardiac complications.