Most anti-cancer drugs can affect the cardiac pumping function

Cancer therapy has been at receiving end for quite some time now. A few years ago, a British doctor shot to fame when he refused to accept modern medicare for his cancer treatment. He opted to die of cancer than suffer from the adverse effects of its therapy. Recently, a lady who claimed to have found a cure for cancer in fruits and vegetables died of cancer, too. A film actor and director managed to stall a government proposal to start a cancer center in central Kerala, out of his conviction that modern medicine has no cure for cancer and cancer drugs if dumped is capable of killing the entire fish population of the Arabian Sea. Not just that, someone even put a fake post in the name of a celebrated oncologist on Facebook promoting alternative therapy for cancer, which was then shared widely. 

Why is cancer treatment alone is singled out by the public and lamented at? Why do those who have no basic training in medicine call the shots in cancer care? Why are oncologists and others involved in cancer care taken for granted as agents of multinational drug firms trying to sell expensive concoctions to unsuspecting cancer victims?

Statistics tell us that cancer survival rate has improved by over sixty per cent during the last 40 years, owing to advances in chemotherapy, oncosurgery, radiation, oncology, imaging sciences and other supportive specialties including oncocardiology. Cancers like nasopharyngeal cancer, pancreatic cancer and cancers among young adults have less impressive cure rates. Breast and prostate cancer are curable. These patients when diagnosed and treated appropriately, do not die of cancer, but of other illnesses. Evidence-based medicine has proved beyond doubt that alternative therapies and nature cure is not effective for treatment of cancer.

Why do people expect a cure for cancer like a common cold, malaria, or an infective diarhoea? Anti-cancer drugs have significant side effects and sensitive dose ranges. Most anticancer drugs can potentially affect the heart, especially cardiac pumping function leading to heart failure. Some can cause elevation of blood pressure, cardiac rhythm abnormalities, heart attacks, venous thromboembolism and even new cancers. Reports show that immunotherapy too can cause fulminant heart failure. 

A pertinent question arises here. If these medications cause such damage, why they should ever be used? Reason: They cure cancer. We see more and more people with adverse effects because patients survive cancer and live longer. If they were dead, you won’t get to see adverse events too. More patients are alive with cancer, so you see more relics of cancer.As life expectancy improves, and population survives infectious diseases out of better living standards, antibiotics, vaccination and social engineering, lifestyle disorders and cardiovascular disease by improvement in physical activities, diet modifications, medications, other interventions and conquer death out of it, then it is a biological plausibility that most of us will catch cancer or degenerative disorders in due course of time. Unlike many doomsayers scream, life expectancy is improving all over the globe, including in some of the most underprivileged societies.

This is a reality. When population ages, natural conditions like cardiac illnesses, cancer, kidney failure and degenerative diseases will be on the rise.We will have to live with all of these maladies. Scientific approach to issues are critical and government policies will be crucial. Radical changes in health care delivery systems will become the need of the hour, hospices will become more relevant that can accommodate and care for people who need attention, short of hospitalisation. We will have to promote research; improve social infrastructure, public conveyances, and social security. That is the way population will live longer, healthier and better. 

Can you imagine even someone like Steve Jobs was a fan of alternate therapies for cancer and died out of an eminently treatable form of cancer of the pancreas denying us more advanced iPhones, iMacs, and iscreens?

The author is an Interventional Cardiologist, with a special interest in cardiac involvement in cancer therapies. He was a fellow in cancer biology and therapeutics.

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