Know your risk
Cancer treatments that can affect the heart include:
Cancer treatments that may increase risk for diabetes:
- Radiation to the abdomen (belly) or pelvis
- Bone marrow transplant (especially if treatment included total body irradiation)
Lower your risk
While nothing can change the treatment you had, there are many things survivors can do to stay healthy and avoid problems later.
Weight loss
Maintaining a healthy weight can lead to lower blood pressure, cholesterol, and blood sugar. This decreases your risk of heart disease, coronary artery disease, stroke, and diabetes.
Studies show that even a 5% weight loss achieved by diet changes and increased physical activity can greatly improve health. A 5% weight loss would mean a weight loss of:
- 7.5 pounds in a 150-pound person
- 10 pounds in a 200-pound person
- 12.5 pounds in a 250-pound person
- 15 pounds in a 300-pound person
Sometimes lifestyle changes alone can help you achieve your weight goal. But some studies have shown that many childhood cancer survivors have a hard time losing weight through lifestyle changes alone.
Weight loss surgery and drugs
Many adult survivors of childhood cancer have questions about weight loss drugs and surgery as possible weight-management options. In general, surgery is for people with severe obesity or major health problems related to their obesity.
Medicine options may be helpful for people who are:
- Obese: A body mass index (BMI) of 30 or higher
- Overweight with a BMI or 27 or higher and at least 1 serious health problem related to being overweight. These problems include high blood pressure, high cholesterol, or diabetes.
Calculate your BMI
BMI is the relationship between weight and height. A recent St. Jude LIFE study found that survivors who had weight-loss surgery had a 60–70% lower chance of having high cholesterol, prediabetes, or liver problems.
So far, there are no large studies of the long-term effects of weight loss drugs in childhood cancer survivors. Studies in the general population have shown that some weight-loss drugs can help reduce the risk of heart problems and diabetes.
“If weight-loss drugs are something that your doctor feels would benefit you because of your weight or diabetes, then they could be an option for you” Dixon says. “We don’t have survivor-specific reasons not to take these medications. But you can also discuss the possible risks and benefits with your doctor.”
Work with your health care provider
Your primary care provider is 1 of your key health partners. Find a care provider who is familiar with heart health and how cancer treatment can impact it.
Visit your provider at least 1 time a year for a checkup. These visits should include:
- Height and weight to calculate BMI and discuss if your weight is in the healthy range
- Blood pressure check
- Blood cholesterol test every 1 to 5 years (how often depends on your risk factors), survivors with history of radiation to the belly should be screened every 2 years
- Blood glucose test or hemoglobin A1c for many every 2 to 3 years, survivors with history of radiation to the belly should be screened every 2 years
- For survivors with certain cancer treatments that increase risk for heart failure, an echocardiogram (echo) may be needed every 2 or 5 years.
