What does the latest research say about cancer's relationship with other health areas? Duke experts sound off.

What is the connection between the heart and cancer?

Pamela Douglas, MD, MACC
Ursula Geller Professor of Research in Cardiovascular Diseases

Chemotherapy can be very effective in curing cancer. It is extending the lives of many patients fighting this disease. However, while patients are living longer, some of them are developing heart disease.

Heart disease can be a side effect of chemotherapy, especially anthracyclines, a type of chemotherapy that may cause heart weakening in up to one-quarter those patients receiving it. Even the side effects of the newer targeted therapies such as Avastin and Herceptin include an increased risk of high blood pressure and heart disease.

At Duke, we are conducting studies so that we can better understand the risks of heart disease in cancer patients. We are studying the cardiac side effects of new cancer drugs closely during the clinical trial phase. We also want to look for improved diagnostic tests so that we can identify problems of the heart earlier in cancer survivors.

Patients who are receiving chemotherapies should not stop taking these powerful and life-saving medicines. However, even more than everyone else, they should eat a healthy diet, exercise, quit if they are smoking, and get regular screenings of blood pressure and cholesterol levels.

Is there a relationship between cancer and exercise?

Lee Jones, PhD
Exercise Physiologist and Assistant Research Professor

Unfortunately, there has not been much research to determine how exercise may improve heart health in cancer patients. However, at Duke we are leading studies to investigate the effects of exercise on patients with different types of cancer.

We are actually doing the first clinical trials among breast cancer patients to determine if exercise helps to protect their hearts and improve the efficacy of their chemotherapy at the same time.

I am also researching how exercise training and a patient’s functional capacity (i.e., aerobic and muscular strength) impacts other aspects of cancer management including the effectiveness of their treatment, the extent of treatment symptoms, cognitive function, chance of recurrence, and quality of life.

I truly believe that all cancer patients can benefit from regular exercise regardless of their disease stage and level of functionality.

Does exercise improve a patient’s mental health as well?

Amy Abernethy, MD
Director, Duke Cancer Care Research Program

I am conducting research that explores how cancer survivors can live a healthy life both physically and mentally. Depression impacts about 20 to 25 percent of cancer patients, and heart disease is correlated with depression.

We are working to improve the psychological and quality of life issues for cancer patients, which may also partially lower their risk of heart disease. We also believe that exercise may play a role in improving the quality of life in cancer patients.

Why is the Duke Comprehensive Cancer Center interested in studies involving exercise and heart health?

H. Kim Lyerly, MD
Director, Duke Comprehensive Cancer Center

A major advantage that the Duke Comprehensive Cancer Center has over many other cancer centers is that we have researchers from a wide variety of departments collaborating with each other. While cardiology and oncology appear at first glance to be unrelated, it has become increasingly more evident that the two are intertwined.

Studies have found that drugs that help cancer patients fight their disease can also increase the risk of heart problems later. We need to understand why this happens. More importantly, we need to understand how we can protect our cancer patients from developing heart problems.

Duke is fortunate to have outstanding faculty members who are experts in oncology and in cardiology. We have consistently ranked among the top 10 in both specialties by U.S.News & World Report.

The connection between cancer and the heart is an important area of study, and at Duke we are well-equipped to continue to make important discoveries in these areas that will improve the lives of our patients.