Breast cancer survivors ‘may not need heart drugs for life’, trial finds
A new study found that 98% of patients in the group who stopped taking medication had no change in heart function after one year
The majority of breast cancer survivors whose treatment caused heart problems may not need to be on medication for life, according to a first-of-its-kind trial.
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The findings would be “hugely encouraging” for thousands of women whose heart health has been affected by lifesaving cancer treatment, experts said.
Currently, some breast cancer therapies can weaken the heart, with medication then required to protect it.
However a new study, funded by the British Heart Foundation and presented at the European Society of Cardiology Congress in Munich, involved 90 women across four hospitals in the UK, whose hearts had recovered after a specific type of treatment for breast cancer.
Most were in their 40s and 50s and would normally have been advised to stay on heart drugs for life, primarily over concerns that their heart function would decline if they stopped.
However researchers found that 98% of patients in the group who stopped taking medication had no change in heart function after one year, with just one woman developing a problem with her heart’s pumping ability.
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Women who came off the drugs also reported, in questionnaires, a better quality of life.
Professor Charlotte Manisty, head of clinical cardiovascular science at University College London and consultant cardiologist at Barts Heart Centre and University College Hospitals London, led the trial, which is published in the Heart Journal.
“Modern breast cancer treatment is a remarkable success story. But the damaging effects of these drugs on the heart leaves survivors and their doctors with difficult questions about ongoing treatment to maintain their heart health," she said.
“Our study provides the first evidence that heart failure therapies can be safely stopped in survivors whose hearts have recovered, with the support of ongoing close monitoring.
“We hope these findings will be encouraging for survivors and their doctors, giving hope for a future free from treatment.”
Lucy Shepherd, from Hertfordshire, took part in the trial after being diagnosed with breast cancer shortly after turning 33.
Tests during her care showed her heart function had declined and she was put on medication before starting another round of treatment.
Ms Shepherd, now 39, said: “Living beyond my cancer treatment was difficult because no-one could tell me whether I should stop or continue taking my heart medication.
“As I got fitter after my cancer treatment ended doctors gradually reduced my heart medication dosages, but I was still having side effects like a low heart rate and fatigue. I also had the mental burden of remembering to take them and the worry of what would happen if I missed a dose.
“Being part of the trial and having the chance to come off my heart medication has definitely improved my life.
“I’m still taking hormone therapy, but I don’t live with the same fear I once had. It has helped me to trust my body again – I feel strong and I know I can take on new challenges now.”
The women involved in the trial will be followed up over the next five years to monitor their heart health.
Dr Sonya Babu-Narayan, clinical director at BHF and consultant cardiologist, said: “These findings will be hugely encouraging for the thousands of breast cancer survivors whose heart health has been affected by lifesaving cancer treatment.
“The study results give hope that many women will be able to safely stop medicines once their heart has recovered.
“The importance of ongoing monitoring is highlighted by the one study participant whose heart scan showed her heart function deteriorated but then bounced back when her heart treatment was restarted.
“More research is needed and the women will be followed up for longer, but in the meantime the good news for this group of breast cancer survivors is lifelong medications after heart complications need not be the default.”