CANCER patients are developing “unacceptable” and life-threatening heart problems after undergoing newer, targeted chemotherapy drugs, cardiologists have warned.

While the outlook for people diagnosed with cancer has improved dramatically, heart specialists say the cardiovascular side-effects of some treatments is of increasing concern, potentially swapping “one diagnosis for another.”

Targeted drugs are technically chemotherapy but aim to kill cancer cells without destroying normal cells, unlike traditional, intravenous forms and are generally used in more advanced cases.

However it is now known that some cause high blood pressure and can impair the pumping activity of the heart, leaving patients at risk of heart failure, heart attack, stroke and kidney failure. 

One Scottish cancer patient, Margaret Neil, 72, from Kilmarnock, was taken off a treatment after her heart function went from normal to “severe dysfunction” within four weeks with no history of heart disease in her family.

She has now been switched to another treatment, her condition has improved and she is taking part in a major Glasgow University study, which is trying to better understand what causes side effects and identify patients who are most at risk. 

Cardiologists believe heart damage may be reversible if caught early and cautioned against alarm saying patients prescribed such drugs are always closely monitored and the numbers affected may be “smaller than anticipated.” The drugs are also generally used in patients who have limited treatment options.

Dr Ninian Lang is leading the project at the University of Glasgow’s Institute of Cardiovascular and Medical Science, which was funded by British Heart Foundation Scotland.

He said: “There has never been such an optimistic time for anti-cancer treatment as there is now. 

“However, the cardiovascular side effects of some treatment options are an increasing concern.

“This means that we need to be really focused on making sure that patients don’t swap a cancer diagnosis for heart and blood vessel complications.

“We are looking at the effects of angiogenesis inhibitors (a form of targeted therapy). There may be some overlap between the target in the cancer as well as blood vessels and the heart. 

“We do not really know how often these effects occur and if these are anything more than mild for the majority if they occur. 

“We think that at least some of these problems may be reversible if caught early but we need to know more about how and when they happen. Because these are newer drugs, we don’t have the same body of research.

“We are working closely with colleagues at the Beatson West of Scotland Cancer Centre because we want patients with cancer to get the best treatment while minimising unacceptable heart and blood vessel side effects or risks. 

“It seems to be if you recognise it and treat with conventional heart medicines and reduce or interrupt the dose of the targeted therapy, even temporarily, you can have a reversal of the effects.

“What we don’t want is for people to be in the position where they have irreversible problems with their heart.”

The study will run over the next three years and will involve regular scanning and monitoring of cancer patients before, during and after treatment.

Dr Lang said: “Our research should help doctors to predict which patients are more likely to be affected and to develop better ways of preventing or treating them.”


MARGARET Neil, 72, believes she is only alive today because she was put forward for a Glasgow study that is looking into the potentially, life-threatening side-effects of newer, targeted cancer drugs.

Margaret, a grandmother of three, from Kilmarnock, in East Ayrshire, was diagnosed with advanced kidney cancer last year after complaining of severe nausea.

She said: “It started in March, I was feeling very sick. Even cooking for the children was making me ill.

“My doctor said I was anaemic and treated me for that and a urine infection but they couldn’t understand why my blood was still thin.

“I saw another doctor and he sent me for a scan and I was diagnosed with renal cancer. It was in my liver and kidney.”

Kidney cancer, also called renal cancer, is one of the most common types of cancer in the UK and usually affects adults in their 60s or 70s.

It is rare in people under 50 and can often be cured if it’s found early. 
Symptoms include blood in the urine, a persistent pain in the lower back or side.

Doctors said surgery wasn’t an option for Margaret because the cancer was in in her liver and she was prescribed a type of targeted chemotherapy treatment known as an anti-angiogenic.

When a tumour has reached 1 to 2mm across, it needs to grow its own blood vessels in order to continue to get bigger.

Anti-angiogenic drugs are treatments that stop tumours from growing their own blood vessels. If the drug is able to stop a cancer from growing blood vessels, it might slow the growth of the cancer or sometimes shrink it.

Some drugs block vascular endothelial growth factor (VEGF) from attaching to the receptors on the cells that line the blood vessels. This stops the blood vessels from growing.

An example of a drug that blocks VEGF is bevacizumab (Avastin) which is used with several types of cancers including ovarian and was prescribed in Margaret’s case.

Margaret says the drug left her “breathless, exhausted and barely able to walk.” After complaining about her symptoms she was asked if she wanted to take part in the study. 

Scans showed the treatment had caused her heart to go from normal to severe dysfunction.

She said: “Having never had a history of heart problems, I suddenly found myself getting very breathless. I was really weak. I could hardly walk and when I did I needed to use a stick.  

“I was knocked off my feet.

“When I was at an appointment, they said to me, before you go there’s a doctor who setting up a study with these pills because they seem to be affecting some people’s hearts. 

“Thankfully because I was in the study, it was picked up by the doctors who identified the problems it was creating for my heart.

“If they hadn’t put me on the trial, I wouldn’t be standing here today. My heart was in such a bad state, it would have conked out.”

Margaret said her side-effects have now all but disappeared after she was switched to an immunotherapy treatment, which aims to boosts the body’s natural defences to fight cancer.

Margaret, who is married to Roy, 74, had a scan last week and is due to get the results today. She says her three grandchildren are the reason she is “fighting so hard.”

She said: “It’s going well, it doesn’t make me tired and I’m feeling a lot better. I can get out and about and see my grandchildren.

“It hasn’t shrunk the cancer yet but everybody responds differently. It’s keeping it at bay, it hasn’t grown.”