Drop in ejection fraction after chemoradiation

Hi @cometsmom, chemoradiation can play havoc on the heart. Have you heard of cardio-oncology?

Cardio-oncology offers expertise in addressing heart problems, potential or current issues during cancer treatments. At Mayo Clinic for example, the Cardio-Oncology Clinic (https://www.mayoclinic.org/departments-centers/cardio-oncology-clinic/overview/ovc-20442193) evaluates people prior to cancer treatment and patients who have experienced side effects due their treatment.

Fellow esophageal cancer members like @aheid @scared2017 @pj03 @lori57216 might have further experiences to share with you. It's good that the cardiologist is monitoring your husband's heart health and working with the oncology team.

I'll be interested to hear what you learn after speaking with the cardiologist today.

Hi all, Jeff is going to start Entresto and have a follow visit in 2 weeks with a repeat echo in 3 months. If not improving, he's recommending an ICD. I asked about a cardio oncologist but we decided he's in good hands with our current team. This is so disheartening. We are expecting the endoscopy biopsies any day. I pray they're good. It is one thing after another. The cardiologist said the worsening in heart function is most likely from the radiation, which is why I was against it, but what other choice did we have? Sorry so negative tonight

Understandable. But something had to be done or his EC was going to kill him anyway. Beta blockers and diuretics are common. How labored is his breathing? Let's see how much he improves as time passes. What distant metastasis is there at this time? What first line treatments did he do and when was he initially dx'd? Stage 4 from the start?

Sorry to hear of his exacerbated heart problems. The cardiologist will give you the very best info and options. Oncologist will modify agents if any are cardiotoxic. Best to get advice from these professionals. I developed Tricuspid insufficiency and Aortic regurgitation from chemo and I am being monitored. Hopefully you will see these MD's sooner than later because the wait is so stressful as you are quite aware. I wish your husband nothing but the best. Hang in there.

He's not short of breath at all thank goodness. The leg swelling is really the only issue as far as the heart failure goes, with fatigue that's probably more related to the rad and chemo he finished up last month. He was first dx'd in 2018 stage 4 with mets to lymph nodes, liver and peritoneum. NED after 2.5 years chemo. He first had the 96 hour 5-FU pump, then carbo/taxol, then FOLFIRI. He has no mets anywhere this time, stage 3. He had 6 weeks carbo/taxol and 25 or 28 radiation treatments this go round. He'd been NED nearly 4 years before the recurrence.

The heart attack he had at 48 was so bad and caused so much damage. The doctors couldn't explain how he survived it, but he did! We were in complete shock that it happened and learned to live with that fear. Then the EC came, bringing all that fear of the unknown back. I know no one is promised tomorrow and everyone dealing with these terrible diseases know better than anyone. I'm just whining I guess. I want this all to be done. We have no biopsy results back as of now. Ughhh. Thanks for listening to me vent

I've forgotten we chat everywhere Lynn... SmartPatients too... you're cometsmom over there as well. Zoom calls too? Sheeesh... my mind is getting fried. Hang tough.

Gary

Hahaha, I knew you'd figure it out Gary 😉. Thanks for everything you do to help people on the journey.

Lynn

Saw the negative biopsy results in MyChart literally 5 mins before seeing the oncologist today. Jeff is in remission again 🥳 Thank god this is ending. The dr had wanted to talk about consolidation chemo which helps keep you in remission but Jeff's heart's not healthy enough for it right now at least. See what the echo shows after three months on the new med. overall great news!

We saw the cardiologist Tuesday for follow up. They are adding Jardiance to the Entresto that was recently started. He will be starting cardiac rehab next month with another echo to follow at the end of September. I'm glad about the cardiac rehab as it helped him feel better and regain strength after his heart attack years ago. He thinks he has less fatigue since starting the entresto. Hoping this new med will help even further. Is anyone else on this combo for heart failure? He's also been on his usual meds for high BP as well as others and those won't be changed. Any thoughts appreciated.

I have EC stage 4 with spread to spine. I started treatment with palliative radiation ( 10 sessions) which were not to shrink tumors but to deaden pain receptors in the spine to address severe pain. ( it didn’t have much effect) the same week I started radiation I started chemo which I’m now in round 4 and next week I’ll have 2nd round keytruda and one starting with “her” can’t recall name next week. I’m thankful the tumors haven’t hurt my heart and the radiation oncologist assured me it would not cause problems- I only had a bad case of esophagitis which has cleared up. The oncologist said one of the immune drugs can attack heart muscle so they will monitor via echocardiogram. I had one routine ( before diagnosis during a cardiac work up to determine cause of chest pain) couple months ago which I assume was normal and serves as a baseline. I have no heart disease beyond high calcium score but no blockages. I hope I tolerate the therapy and don’t have to stop due to heart damage.
I hope your husbands heart function improves with treatment, as he goes through EC treatment.