Does cancer treatment affect the heart?

Some cancer treatments can affect how your heart works. This may cause heart problems that are either short-term (temporary) or long-term (permanent).

Problems may develop during or soon after cancer treatment. Some problems may develop many years later.

The risk of heart problems depends on the type of cancer treatment you have and how much treatment you have.

Your risk may be higher if:

Before you have cancer treatment, your cancer doctor will explain your treatment plan. They will tell you about any possible benefits and disadvantages of the treatment, including any possible risks to your heart.

If you are worried about heart problems, ask them for more information.

We have more information about heart health and treatments, including:

  • chemotherapy
  • targeted and immunotherapy
  • radiotherapy
  • hormone therapy
  • surgery.

Your cancer doctor may talk to you about having cancer treatment as part of a clinical trial. Clinical trials test new treatments or new ways of giving treatments.

Before you decide if you want to take part, your doctor or a clinical researcher will explain the trial. They will give you information about any known side effects of the treatment.

They may not know all the effects these treatments have on the heart. If you join the trial, you will be monitored closely for side effects.

If your treatment has finished

If your treatment has finished and you are worried about your heart, talk to your GP. Sometimes it is hard to remember the details of your cancer treatment. Your cancer doctor or your GP can give you more information and answer any questions you have.

If you had cancer treatment as a child, you may have a higher risk of developing heart problems as an adult. This depends on the type of cancer treatment you had.

Some people will have regular follow-up appointments for the rest of their life to check their heart health.

Heart checks before cancer treatment

Before you have cancer treatment, your cancer doctor may check your heart health. They will ask whether you have any heart problems or risk factors such as:

  • high blood pressure
  • high cholesterol
  • diabetes.

They will ask what treatments you have had or are having for these conditions. If you are not sure or cannot remember the name of a condition or treatment, check your medical notes. Your cancer doctor might also speak to your GP or cardiologist (heart doctor).

You may also have tests to check your heart health. For some cancer treatments, you may have these tests even if you do not have heart problems. Tests can be repeated during and after treatment to check for any heart changes.

Making treatment decisions

Making a decision about your cancer treatment can be complicated. For many people, the possible benefits of cancer treatment are greater than the risk of possible heart problems later in life. But it is your decision.

Your doctor and nurse will help you understand the benefits and risks of having treatment. It is important to understand this information before you decide what is right for you.

You will normally have time to think about your decision, and have another appointment with your doctor or nurse to discuss it.

We have further information about making treatment decisions.

If you have a heart condition before cancer

If you already have a heart condition, this may affect the cancer treatment you have and how it is planned. Your cancer doctor will talk to you about this. It is important to tell them about any heart problems you have so they can plan your treatment safely.

We have more information about having cancer treatment if you have a heart condition.

If heart problems develop

If you develop heart problems during or after cancer treatment, your doctors will talk to you about the best way to manage them. Heart problems are often treated with medicines. Some conditions are treated with a heart procedure or surgery.

Your cancer doctor may arrange for you to see a heart doctor (cardiologist) for advice. Some heart problems will be managed and monitored by your GP.

If you are having cancer treatment when the heart problem starts, your cancer doctor may suggest changing your treatment to prevent further damage. These changes may include:

  • stopping cancer treatment for a time
  • lowering the dose
  • changing to a different treatment that is less likely to cause heart problems
  • stopping cancer treatment completely.

Heart problems symptoms

If you have any warning signs of heart problems, it is important to let your doctor know straight away. Early treatment for a heart problem can prevent further problems.

Sometimes the symptoms of heart problems are like the symptoms of other conditions. But it is important to get any new symptom checked by your doctor. Always tell your doctor if you:

  • have chest discomfort, pain or tightness
  • have pain that spreads to your arm, neck, jaw, stomach or back
  • feel short of breath
  • feel unusually tired or weak (fatigue)
  • have swelling in your feet, ankles, tummy or lower back
  • have palpitations, which might feel like a thumping or fluttering in your chest have blackouts (fainting) feel dizzy or light-headed.

A heart attack is life-threatening. If you think you or someone else is having a heart attack, phone 999 for an ambulance straight away.

Heart checks after cancer treatment

If you develop any symptoms of heart problems (above) during or after cancer treatment, tell your doctor straight away. They will assess you and arrange any tests or treatment you need.

Some people will have regular follow-up appointments to check their heart health after cancer treatment. This is useful for people who:

  • developed a new heart problem during cancer treatment
  • developed heart changes during cancer treatment
  • had a cancer treatment that may cause heart problems many years later
  • have other risk factors for heart problems.

Follow-up appointments may be with a GP, practice nurse or a member of the cardiology team at the hospital. You may have regular blood pressure or cholesterol blood tests. Some people will have scans to check how the heart is working. Ask your cancer doctor or GP for more advice about your situation.

If your cancer treatment is unlikely to cause heart problems, you may not need follow-up appointments.

But if you have other risk factors for heart problems, you can talk to your GP or nurse. They can give you information about your risk of future heart problems and how to reduce your risk. They can also talk to you about a health check to assess risk of heart disease and other conditions.

Keeping your heart healthy

You can improve your heart health at any age, even if you already have a heart problem. Making changes such as eating well or stopping smoking can help before, during or after cancer treatment. Even small lifestyle changes can make a difference. Keeping your heart healthy is important throughout your life, not just during cancer treatment.

If you need more advice or support with keeping your heart healthy, talk to your doctor or nurse.

Tips for heart health

  • Healthy eating
    A healthy diet can help prevent some heart problems. It can also help with weight control, high blood pressure, cholesterol levels and diabetes. The British Heart Foundation has more information about healthy eating.
  • Limit alcohol intake
    It is also important to avoid drinking too much alcohol or binge drinking. This can increase the risk of heart problems such as arrhythmias and high blood pressure. This can also damage the heart muscle. There is more information about alcohol and drinking guidelines at drinkaware.co.uk.
  • Keep to a healthy weight
    If you are overweight, losing weight will help to protect your heart. Cancer and cancer treatment can cause problems that may make keeping to a healthy weight more complicated. We have more information about healthy eating and managing your weight. If you want and need to lose weight, the British Heart Foundation has more information.
  • Keep active
    Regular physical activity helps to keep your heart healthy. It can also help control risk factors for heart disease, such as:
    • high blood pressure
    • high cholesterol
    • being overweight
    • diabetes.
    • We have more information about ways to keep active.
  • Stop smoking
    If you smoke, giving up is the best thing you can do for your heart. After you stop smoking, your risk of developing coronary heart disease or having a heart attack dramatically reduces. We have more information on giving up smoking. The British Heart Foundation also has information about stopping smoking.

The British Heart Foundation has more information about how to keep your heart healthy.

Coping with stress

Cancer can be stressful for lots of reasons. You may be dealing with some difficult emotions, worrying about the future, and coping with treatment and side effects.

Stress can raise your blood pressure and put more strain on your heart than usual. Smoking, drinking alcohol or over-eating to cope with stress can also increase the risks to your heart.

If you already have a coronary heart disease (CHD), feeling extremely stressed or anxious can sometimes cause symptoms such as angina.

It is important to find healthy ways of coping with stress. You could try some of these ideas:

  • Talk about it. This is not always easy, but it can often help you feel better. You may want to talk to someone you know well, such as family or friends. Or you may decide to talk to your GP or nurse specialist, or a religious leader.
  • Ask for more support. If you have questions about your treatment or other worries, ask your doctor or nurse. And if you feel you need more help to cope, let them know.
  • Work out what makes it worse. Once you know what makes you stressed, avoid these things or get help so you can cope with them.
  • Find ways to relax. You could try listening to relaxing music or doing some physical activity, such as walking, swimming or yoga. Some people find that complementary therapies help, such as a massage.

The British Heart Foundation has information about heart health and coping with stress. And there is further information about coping with stress on the NHS Moodzone website. If you want to talk about how you are feeling, you can call the Macmillan Support Line on 0808 808 00 00.

Pregnancy after cancer teatment

Pregnancy and giving birth can put pressure on your heart. Women who are thinking about having a baby after cancer treatment should ask their doctor for advice.

Your doctor may arrange for you to see a cardiologist. They can give you specialist advice before or during your pregnancy. You may also have extra tests to check your heart health while you are pregnant.

About this information

Our information about heart health and cancer was developed in partnership with the British Heart Foundation.

If you have questions about your heart health, call the Heart Helpline on 0300 330 3311, Monday to Friday, 9am to 5pm, or visit bhf.org.uk.

We have information about:

  • tests you may have before, during and after cancer treatment to check your heart health
  • the impact treatment may have on your heart
  • treatments for heart problems
  • tips for keeping your heart healthy.

The British Heart Foundation also have information about heart conditions and other risk factors.

You can also download our booklet heart health and cancer treatment [PDF].

Related Stories & Media

Booklets
22 Feb 2019
The booklet explains how the heart works and how different cancer treatments may affect the heart.

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