Cardiooncology Munich

Chemotherapy is the use of special drugs that kill cancer cells or slow down their growth. It is mainly used when tumour cells have spread in the body or a relapse is to be prevented.

However, some of these drugs not only act against tumour cells, but also attack healthy heart muscle cells. This is because the active substances intervene very strongly in the metabolism and do not always differentiate precisely between cancer and heart tissue. They then attack the "power stations" of the cells (mitochondria) and the genetic information (DNA).

This causes the heart muscle to lose energy and stability. It is less able to contract and its pumping power decreases. This can result in heart failure (cardiac insufficiency). The medication can also change the electrical signals in the heart and thus favour cardiac arrhythmia.

High-energy radiation is used to destroy the tumour cells and stop their growth. This treatment is often used for cancers in the chest, e.g. breast cancer or lymphoma.

Even if radiation is used in a targeted manner, it is not always possible to completely spare the surrounding tissue. If the Heart in the radiation field, the heart muscle, heart valves and coronary arteries can be affected.

The result: vessels can constrict, the tissue hardens or inflammation develops. In the long term, this increases the risk of circulatory disorders, heart valve disease or heart failure.

Some of this damage only occurs years after radiotherapy and makes regular monitoring particularly important.

Immunotherapy uses the body's own defences to fight the tumour cells. So-called checkpoint inhibitors are used most frequently. They are usually administered as an infusion into the vein, sometimes also as an injection under the skin. Only a few preparations are available in tablet form. Treatment usually takes place at regular intervals on an outpatient basis in an oncological practice or clinic.

By activating the immune system, the body is better able to recognise and destroy tumour cells. However, the immune system sometimes also attacks healthy tissue - including the heart. Possible side effects are therefore inflammation of the heart muscle (myocarditis), cardiac arrhythmia or high blood pressure.

For this reason, immunotherapy requires particularly careful monitoring and close control of cardiac function.

In some types of cancer - e.g. breast cancer or prostate cancer - the body's own hormones play an important role in the growth of tumour cells.

Hormone therapy blocks the effect of certain hormones or lowers their levels in the body. This slows tumour growth or even stops it altogether. The treatment usually involves tablets or injections and usually extends over a longer period of time.

Even if hormone therapy does not directly affect the heart muscle, it influences the entire metabolism. It can increase blood lipid levels, change blood pressure or increase the risk of diabetes. All of these factors put a strain on the heart and blood vessels and can favour cardiovascular diseases in the long term.

Targeted therapy comprises modern drugs that block very specific structures or signalling pathways of tumour cells. These include, for example, tyrosine kinase inhibitors or monoclonal antibodies.

In contrast to classic chemotherapy, they work more precisely: they are designed to inhibit the growth of cancer cells without putting too much strain on healthy tissue. Treatment usually takes the form of tablets or infusions.

Despite this targeted mode of action, side effects affecting the heart and circulation can also occur. Some active ingredients increase blood pressure, others lead to fluid retention (oedema) or weaken the heart muscle. Cardiac arrhythmias are also possible. Close cardiological monitoring is therefore particularly important during targeted therapy.

We check the heart function before starting cancer therapy in order to determine the current status. In addition to a detailed medical history and a physical examination, this also includes ECG, Exercise ECG and a Echocardiography (Ultrasound of the heart). Depending on your individual case, a Cardiac MRI as well as special blood tests.

This gives us a clear picture of the initial situation of your heart.

During your cancer treatment, we keep a constant eye on your heart function. To do this, we carry out ECG and ultrasound examinations at fixed intervals to measure the heart's pumping power and recognise possible changes immediately. If necessary, we supplement these with stress tests, laboratory values (heart markers in the blood) or a cardiac MRI.

These close checks enable us to detect even minor abnormalities at an early stage. This allows us to react in good time, e.g. with heart-protective medication or by adjusting the therapy.

Not every heart reacts in the same way to cancer therapy. That is why we always tailor the treatment to your personal situation. If it makes sense, we use heart-protective medication such as ACE inhibitors, beta blockers or diuretics. These preparations can stabilise the heart's pumping power, regulate blood pressure and reduce the strain on the heart and blood vessels.

We also advise you on accompanying measures in everyday life - such as diet, exercise or dealing with stress.

Even after cancer treatment has been completed, the focus remains on the heart. Some side effects only become apparent months or even years later. That's why we also support you in the long term with regular Control examinations.

In the first few months after treatment, appointments are recommended every 3 - 6 months. If the heart function remains stable, check-ups at intervals of 6 - 12 months are sufficient. As some heart problems only develop years after treatment, annual follow-up care is also important in the long term.

This enables us to recognise and treat possible late effects at an early stage. At the same time, we support you in actively contributing to heart health with a healthy lifestyle. Our aim is to ensure that your heart remains reliable and strong even after cancer treatment has been completed.