Overview
Depending on the cancer you have and your risk of heart problems, you may have tests before starting treatment such as blood tests, an electrocardiogram (ECG) and an exercise stress test.
If your doctor is concerned about your heart health, they may change your cancer treatment, reduce the dose, change how the drug is given or give you heart medicines.
If you need radiation therapy to the chest, the heart can be protected by shielding or special breathing techniques.
What's on this page
Health professionals you may see
Looking after your cardiovascular health during and after cancer treatment is important. If you have existing heart problems or have any risk factors, you may need support in making lifestyle changes. You may see a:
- general practitioner (GP) – a doctor who supports your general health, including your cardiovascular health, before and after cancer treatment. Depending on where you are having your treatment, your GP may also be involved in your care during cancer treatment. If you don’t have a regular GP, it’s a good idea to find one and start building a relationship
- exercise physiologist, physiotherapist – prescribe safe and effective exercise to help restore or improve people’s overall health, fitness, strength and energy levels
- dietitian – helps with nutrition concerns and may recommend changes to your diet during treatment and recovery.
If you have a higher risk of heart-related side effects, you may also see a:
- cardiologist – a doctor who specialises in the treatment of heart disease
- cardio-oncologist – a cardiologist with special training in managing the effects of cancer and cancer treatments on the cardiovascular system; they help to reduce cardiovascular risks and manage cardiovascular problems that may occur
- cardiac nurse – a nurse who specialises in cardiovascular health; may be involved in some heart tests.
After your cancer treatment is finished, your heart health may continue to be monitored by your GP, a cardiologist or cardio-oncologist.
There are also many things that you can do to look after your own cardiovascular health and reduce your risk of any future problems.
Managing heart problems
When planning the cancer treatment, your doctor will consider your risk for heart problems, the type of cancer treatment you need and the results from any heart tests.
If there are concerns about your heart health, your doctor may:
- change the type of cancer treatment to reduce the impact on the heart
- reduce the dose of the cardiotoxic drug so it works well against the cancer but is less likely to cause heart damage
- change how the drug is given. For example, chemotherapy given through a vein in your arm (intravenously) may be delivered more slowly
- prescribe heart medicines to be taken during, and sometimes after, cancer treatment. These can be to treat existing heart problems or to prevent them from developing. Research in this area is ongoing and new drugs may become available. Your doctor will talk to you about the best heart medicine for you.
Heart protection during radiation therapy
Radiation therapy has improved over time. Lower doses of radiation are now used to effectively treat the cancer while reducing the risk to other organs, including the heart.
If you need radiation therapy to the chest (e.g. for breast or lung cancer), the heart can be protected. Shielding in the radiation machine (called a linear accelerator) may be used to block radiation reaching the heart.
A special breathing technique is sometimes suggested. This is called a deep inspiration breath hold (DIBH). You will be asked to take a deep breath and hold it for about 20 seconds while the radiation is given. This technique helps move your heart away from the treatment area, protecting it from the radiation beams.
Even if many years have passed since the cancer treatment, always tell your health professional that you have had cancer and any treatments you had. Cancer will always be part of your medical history.
Cardiovascular tests
Depending on the type of cancer you have and your cardiovascular risk factors, you may have one or more of the following tests before starting cancer treatment.
Blood tests
Blood tests
What does it check for?
If your heart has existing damage or is under strain, the cells may release particular proteins (called biomarkers) into the blood.
How it is done?
A sample of your blood will be collected with a needle from a vein in your arm. It will be sent to a laboratory where a pathologist will check your blood for certain biomarkers.
Electrocardiogram (ECG)
Electrocardiogram (ECG)
What does it check for?
This shows how fast or slow your heart is beating and checks for irregular heartbeats (called arrhythmias). It can also show if you have had a heart attack.
How it is done?
Several leads (electrodes) will be stuck to your chest; any hair on your chest may need to be shaved so the electrodes stick properly. The electrodes are connected to a computer that records your heart beating.
Echocardiogram (echo scan)
Echocardiogram (echo scan)
What does it check for?
This looks at how well your heart muscle and heart valves are working.
How it is done?
This is a type of ultrasound scan. The person doing the ultrasound (sonographer) will spread gel on your chest and then move a small device (transducer) over the chest. The transducer sends soundwaves to a computer to create pictures of your heart.
Cardiac magnetic resonance imaging (CMRI)
Cardiac magnetic resonance imaging (CMRI)
What does it check for?
This scan may be done if an echo scan suggests a more serious cardiovascular problem. A CMRI shows how well the heart is pumping and if the valves are working properly. Most people will not need this test.
How it is done?
This scan uses a powerful magnet and radio waves to create detailed cross-sectional pictures of your heart. During the scan, you may be injected with a dye (called contrast) to help make the pictures clearer. You will lie on a table inside a large metal tube that is open at both ends. The scan is noisy but painless.
Computerised tomography (CT) coronary angiogram
Computerised tomography (CT) coronary angiogram
What does it check for?
This scan checks for any blockages or damage in your heart and surrounding blood vessels. It may be called a CTCA.
How it is done?
A small tube (cannula) will be put into a vein in your arm. You will lie on a table that slides into the CT machine. Dye (called contrast) will be injected into the cannula to help show if there is any narrowing or blockage in your heart arteries. You will be asked to hold your breath for about 10 seconds and stay still while the images are taken.
Coronary angiogram
Coronary angiogram
What does it check for?
This test is used to check if the arteries around your heart (coronary arteries) have narrowed or are blocked. Most people will not need this test.
How it is done?
A thin, flexible tube (catheter) is inserted into the largest artery in your body (the aorta) through your wrist or the groin. It is then threaded up into the coronary arteries. A dye (called contrast) is injected into the catheter, and x-rays are taken to show up any blockages.
Exercise stress test
Exercise stress test
What does it check for?
This measures how well your heart and lungs are working during exercise.
How it is done?
Your heart rhythm and lung function will be monitored while you walk on a treadmill or ride a stationary bike. The appointment may take about 90 minutes, but you will only be exercising for 5–15 minutes. An echo scan might be done before and after the stress test. You will be given instructions on what you can eat or drink the day before the test.
Find support services
Find the right services for your needs, wherever you are in Australia
Read cancer information
Trusted cancer information for all people affected by cancer
Need to talk to someone?
We're available 9am - 5pm, Monday to Friday (excluding public holidays)