March 16, 2018

Older colorectal cancer patients are at increased risk of cardiovascular disease, congestive heart failure

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A study regarding health risks in colorectal cancer patients may help develop personalized therapeutic options for patients with pre-existing morbidities.

kenzik williams webGrant Williams, left, and Kelly KenzikOlder patients with colorectal cancer are at an increased risk of developing cardiovascular disease and congestive heart failure, according to a study published in Journal of Clinical Oncology. The study also finds that morbidities such as diabetes and hypertension negatively interact with chemotherapy designated for colorectal cancer, which adds to the patient’s increased risk for cardiovascular morbidity.

Published by Kelly Kenzik, M.S., Ph.D., assistant professor in the University of Alabama at Birmingham’s Division of Hematology and Oncology and Institute for Cancer Outcomes and Survivorship, the research focused on patients ranging from 66 to 106 years of age, all of whom were diagnosed with colorectal cancer. The study tracked incidence of developing cardiovascular conditions after treatment concluded, with factors such as the patient’s prior history of hypertension and diabetes, and what type of treatment was administered taken into consideration.

It was discovered that the 10-year cumulative incidence of new-onset cardiovascular disease was 57.4 percent, while congestive heart failure was 54.5 percent, as compared to controls who experienced 22 percent and 18 percent, respectively. The results indicated that the use of fluorouracil, a common colorectal cancer chemotherapy treatment, was the cause of significant interactions with hypertension and diabetes, ultimately contributing to the increased cardiovascular disease and congestive heart failure rates.

“This study fundamentally changes the discussion around short-term and long-term chemotherapy outcomes, as the effects of treatment on the development of other conditions have not been studied in a systematic way before,” Kenzik said.

The study tracked incidence of developing cardiovascular conditions after treatment concluded, with factors such as the patient’s prior history of hypertension and diabetes, and what type of treatment was administered taken into consideration.

Study co-author Grant Williams, M.D., assistant professor in UAB’s Division of Hematology and Oncology, added, “Our main takeaways conclude that, if we can recognize the long-term effects of specific chemotherapy agents on patient conditions, we can better support and treat those patients from the start of their treatment.”

The study’s authors note that the same paradigm can be examined as it relates to other cancer outcomes and to the impact that other chemotherapy treatments may have on comorbidities. This will help researchers moving forward best understand the long-term impacts of cancer treatments and the way potential personalized therapeutic options can be utilized in care.

Additional authors included Courtney Balentine, M.D., MPH; Joshua Richman, M.D., Ph.D.; Meredith Kilgore, Ph.D.; and Smita Bhatia, M.D., MPH; all associated with the UAB Institute of Cancer Outcomes and Survivorship.

Both Kenzik and Williams are members of UAB's Comprehensive Cancer Center.