People living with lung cancer may also be diagnosed with cardiovascular disease (CVD). It’s a common lung cancer comorbidity, or a condition that occurs at the same time as lung cancer. Being diagnosed with CVD can impact treatment options and prognosis for those living with lung cancer.
CVD refers to a group of diseases that affect the function of the heart and blood vessels. There are many different types of CVD.
Coronary artery disease, also called coronary heart disease, results from the buildup of plaque in the arteries of the heart. Coronary artery disease impacts blood flow.
This condition also arises due to plaque buildup in the arteries. In contrast with coronary artery disease, peripheral artery disease can cause blockages in the blood vessels in the limbs.
While most forms of CVD arise later in life, congenital heart disease is a condition that is present at birth.
The pericardium is the layer that covers the heart. Some autoimmune disorders and certain types of cancer cause that layer to become inflamed, leading to pericardial disease.
This condition is a disease of the heart muscle itself. It can be hereditary, and it can also be caused by injury to the muscle.
Also called heart palpitations, arrhythmias are abnormal or irregular heartbeats. The condition is caused by an issue with the mechanism that allows the heart to pump blood.
A healthy heart functions by alternating between pumping and relaxing. Heart failure occurs when the pumping mechanisms are disrupted, leading to pain and shortness of breath.
The heart valves are structures that permit blood flow across the chambers of the heart. Heart valve defects can cause problems by inhibiting blood flow through the valves.
Cerebrovascular disease impacts the blood vessels that deliver oxygen to the brain.
A heart attack, or myocardial infarction, is a serious medical event that can occur as a result of CVD. When a blockage is severe, it can completely prevent blood flow through the arteries of the heart, resulting in a heart attack.
A stroke, another serious consequence of CVD, occurs when a blood vessel in the brain bursts, is closed by a clot, or has a blockage. Blood and oxygen cannot reach the brain, causing the brain tissue to die.
CVD is fairly prevalent, affecting about 12 percent of adults overall. While congenital heart disease is present at birth, other forms of CVD are associated with the following risk factors:
The incidence of CVD is higher among people with lung cancer relative to the general population. CVD is observed in about 23 percent of people with non-small cell lung cancer (the most common form of lung cancer). This is partly due to age, as lung cancer is more commonly diagnosed in adults over 65. This population is more likely to have CVD or risk factors for CVD than younger people.
Studies have shown that people with lung cancer are at an increased risk for developing CVD. In many cases, however, CVD is already present at the time of cancer diagnosis. This occurs in part because the risk for both CVD and lung cancer increases with age, so it’s common to find them together. In addition, smoking, which is the primary risk factor for developing lung cancer, is also associated with CVD.
People with CVD are often excluded from clinical trials for cancer therapies; complications of CVD may make it more difficult to properly evaluate the side effects and efficacy of the treatment.
Due to lack of safety data in people with CVD, lung cancer treatments are prescribed at the discretion of the clinician. People with CVD are most commonly treated using chemotherapy and radiation therapy.
CVD has been associated with a negative impact on survival of people with lung cancer. In particular, people with early stage disease have decreased overall survival when CVD is present compared to people without CVD. Decreased survival was observed for people diagnosed with CVD before cancer diagnosis, as well as people with CVD diagnosed during a follow-up visit after cancer treatment.
Living with lung cancer and a comorbid condition is challenging, but there are strategies to manage CVD. Consider adopting healthy habits to manage symptoms of CVD — or to prevent developing CVD if you haven’t been diagnosed.
If you have been diagnosed with CVD, talk with your cardiologist and cancer care team about ways to maximize your treatment options for lung cancer.
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