Chemo saving lives but hurting hearts: Are you among the 71% of patients who face Cardiotoxicity?
Cardiotoxicity, a condition in which cancer treatment or medication causes heart damage, can lead to a number of heart problems such as heart failure, irregular heart rhythms, and cardiomyopathy. Anthracyclines, a type of chemotherapy drug used to treat cancers of the breast, stomach, uterus, ovary, lung, as well as leukemias and lymphomas, have been identified as posing a higher risk of cardiotoxicity.
At the American College of Cardiology’s 2023 Advancing the Cardiovascular Care of the Oncology Patient conference, a new meta-analysis revealed that Black patients or patients of African ancestry are 71% more likely to experience cardiotoxicity following cancer treatment than White patients.
This finding sheds light on the disparity in the incidence of cardiotoxicity between different racial and ethnic groups, and underscores the need for further research and interventions to address this issue.
“Unfortunately, we were not surprised [by the findings],” remarks lead author Wandewossen Gebeyehu.
The study “shows that Black patients have poorer outcomes for almost every disease.”
“In this case, one could have expected that the differences would be minimal since it is the chemotherapy that is injuring the heart, and we would expect the same chemotherapy to be given to Black and non-Black patients with a given cancer. However, this systematic review indicates that the inequities in health outcomes extends to the odds of cardiotoxicity after cancer treatment.”
In a comprehensive study, researchers conducted a systematic search of various databases, such as Medline, Embase, Pubmed, and others, to identify studies that reported on the cardiovascular toxicity experienced by cancer patients of different racial and ethnic backgrounds receiving chemotherapy. After screening a total of 7,057 studies, they ultimately included 24 studies involving 683,749 participants in their final review.
Their findings revealed that Black individuals or those of African ancestry had a 71% higher likelihood of experiencing chemotherapy-associated cardiotoxicity compared to other racial and ethnic groups. Additionally, these patients had a higher probability of being diagnosed with congestive heart failure. These results provide valuable insights into the disproportionate impact of chemotherapy on different racial and ethnic populations, and highlight the need for targeted interventions and further research in this area.
According to Gebeyehu, the lead researcher, these findings could be an indication of the direct impact of racism, specifically structural racism, on the health outcomes of Black patients. The study suggests that the worse determinants of health experienced by Black patients, due to structural racism, may be a contributing factor to their increased vulnerability to disease and decreased access to preventative care.
Additionally, Gebeyehu notes that the underrepresentation of Black patients in clinical trials could lead to the development of treatments that are less effective or more risky for this population. It is therefore essential to investigate and explore all possible factors that may contribute to disparities observed in Black patients.
“Importantly, these results should prompt further inquiry into the many possible contributors to disparities observed in Black patients.”
The researchers note that this study provides a quantitative measure of the heightened risk of chemotherapy-related heart damage in Black cancer patients. Furthermore, they emphasize the importance of conducting further research to identify the root causes of these disparities, so that effective interventions can be developed and implemented to address them.
“The most important message for patients is that they should not avoid chemotherapy, as the most important thing is making sure they get the best cancer treatment possible, and studies already show Black patients may get less optimal cancer treatments,” adds the lead author.
The study underscores the significance of healthcare providers being aware of the increased likelihood of cardiotoxicity among Black patients, and taking appropriate measures to address this issue. With a better understanding of these disparities, clinicians can engage in more meaningful conversations with their patients about mitigating the cardiovascular risks associated with chemotherapy. This may include targeted interventions and individualized care plans tailored to address the specific needs of groups at higher risk, according to the author.
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