I ask because besides the MILBC I've been living with for over 16 years, I've developed a couple of cardiac issues, a leaky mitral value and a-fib. My cardiologist referred me to a cardiac surgeon hoping one (open heart in which the sternum would be cut thru) procedure could fix both. After consulting with my onc, the surgeon said that I am not a candidate for open heart surgery, but so much was going on during that appt I didn't think to ask what led them to that decision. Another one of my specialists saw the surgeon's note in my file and it didn't explain it either and he suggested that conclusion was not one he's agree with if it was based on "life expectancy" because I have done so well for so long. He offered to question them about this which is fine as far as I am concerned. It would allow me to get the blood thinner I am on and would lessen chances of stroke.
I have a phone call in to the NP at the surgeon's office--she's been there at each of my appts with the cardiac surgeons. Appts there always seem to generate a group of 3 cardiac surgeons--one a resident and one their top surgeon and I'm not sure abut #3. Frankly, I'd rather just see one, the top guy of course!
I'd be interested in hearing what any of you think especially if you have had experience with heart issues while living with MBC! Thanks in advance.
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PJBinMI
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I can't help you but am wishing you all the best. I think if I did have waht you have they wouldn't be able to help me because I have cancer in my sternum.
Haven't had any experience yet with cardiac issues, but I do encourage you to press for answers and the treatment that you need. Sending good thoughts your way. Keep us posted, please, on how everything turns out.
I've gotten really good at self advocacy! I think we have to with mbc. I see my onc tomorrow and hopefully she'll have an explanation for the thinking around open heart surgery for me. Depending on what she has to say, I may start arranging a second opinion at the med school med center I go to for second opinions about the bc. Sigh!
Thank you! I've gotten second opinions about the MBC and have been thinking about going there for a second opinion on this. I am fortunate to have great medical insurance and what I need to get second or even third opinions!
I have no experience with cardiac issues but i would like to encourage you to seek a second opinion. Maybe he just isnt comfortable and another surgeon would be. Do you have bone mets? Maybe thats why he says surgery isnt an option?
Thank you. I do have bone mets but not in the sternum. Once I find out what the reasons are that they decided I wasn't a good candidate for open heart surgery, I will call the second opinion bc onc and see what they have in terms of second opinions about this.
Hi PJB, I had open heart surgery in late May, 2018. The bicuspid aortic valve I was born with was replaced with a tricuspid porcine valve. During the surgery, it was necessary to shock my heart twice due to (I think) afib. While in the Cardiac Care Unit, I needed this treatment again. I tell you all this because I now wonder if all this electricity exacerbated my slow-growing metastatic breast cancer.
Taking various heart medications prescribed by my cardiac surgeon and cardiologist, I had no cancer symptoms until six months after I was released from the cardiac unit when the lymphedema in my right arm suddenly became much worse. After extensive testing to determine that I indeed had HR+ metastatic breast cancer, I added MBC meds to my various heart meds.
I originally was diagnosed with breast cancer in 2006 after being on HRT for many years. Three lumpectomies, removal of lymph nodes in my right arm, and radiation therapy led to the "all clear" followed by 5 years of adjuvant tamoxifen therapy. Thus, there was 13 years between my original BC diagnosis in 2006 and my MBC diagnosis in 2019. For this reason, my cancer has been described as "slow-growing", and I am very careful to avoid taking any meds which might make it grow faster.
There is now a medical sub-specialty known as "onco-cardiology" or "cardio-oncology", but I don't know how developed it is, or whether there might be practitioners you could consult in your area. In any case, there are research papers which make it clear that many cancer meds do contribute to heart issues.
For example, the abstract for a 2014 paper in the journal for the American College of Cardiology begins with these statements:
"Atrial fibrillation (AF) has been found to occur with an increased frequency in patients with malignancies, particularly in those undergoing cancer surgery. The occurrence of AF in cancer may be related to comorbid states or a direct tumor effect or may represent a complication of cancer surgical or medical therapy, whereas inflammation may be a common denominator for both conditions. Treating AF in patients with malignancies is a challenge, especially in terms of
antithrombotic therapy, because cancer may result in an increased risk of either thrombosis or hemorrhage...."
It seems to me that cardiologists do need to be very careful when operating on cancer patients like you and me with our leaky valves. My cardiologist bugged me for years about having the surgery. I finally decided to go ahead because I was very short of breath, and he told me that valve replacement would give me my wind back. It didn't, of course, since I had cancer nodules in my lungs. I probably told him at some point that I'd been treated for cancer but he never asked about it. At least in your case, your physicians are well aware of your history! I think the main question for you should be, "What might I gain in terms of life expectancy and strength if I go through with such a major operation?"
If you have any questions I might help you with, please don't hesitate to ask. I'll be thinking of you. Hugs, Cindy
Thank you, Cindy! I am seeing my onc tomorrow and am going to ask her about the cardiac issues. Now, after reading your note, I will ask about cardio-onc or onc-cardio practitioners. I really appreciate reading your words of wisdom. I will also call the Comprehensive Cancer Center where I've gone for second opinions twice.
I was diagnosed with congestive heart failure in 2015. It was determined that it was a side effect of chemo (Adriamycine) that I took in 2006. I was prescribed a Digoxin, Coreg and Lisinopril to raise my EF. At one time I was sent to an Electrophysicist to decide if I would need a defibrillator. We decided at that time to see how medication would help,. It did! My EF has come from <25% to back to normal at 55%. I still take the Coreg and the Lisinopril. Of course my oncology team wanted to dismiss the relation of the chemo to the CHF. Evidently they are just now discovering that there is a correlation between some chemo drugs and heart issues.
For MBC I take Letrozole and Ibrance with quarterly Zometa infusions. I am blessed to have done so well. Please ask questions to your medical team. Good luck!
A short summary of my appt with my onc today....she had advised against open heart surgery to repair my A-fib and leaky mitral valve as she is concerned that exposing my chest to oxygen could result in growth and/or spread of cancer cells. She said I could go ahead and have it if I wanted to. She did agree to refer me to the big medical complex, med school affiliated, where I have gone for second opinions with bc specialists in the past, to see an onco-cardiologist or cardio-oncologist. So that is a big relief! I'll have more respect for opinions I get there........
Thanks again for all the support and info you have given me here!
I think I will sing "I'm off to see the Wizard, the wonderful Wizard of Oz" on my way across the state for that appt! lol Don't know what I would do without my sense of humor!
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