Advances in childhood cancer treatments over recent decades have dramatically improved survival rates. This has enabled millions of children globally to survive cancer and to have a hopeful future. The therapies used to eradicate cancer, such as chemotherapy, radiation and other targeted biological therapies, however, may be permanent to the normal organs.
Radiation therapy and some cancer treatments can also cause cardiotoxicity that causes damage to the heart tissue. Read on to know more as we reached out to Dr Ankur Nandan Varshney, Senior Consultant, Medical Oncology, Haematology and Bone Marrow Transplant at Medanta Hospital, Noida.
How Are Childhood Cancer Treatments Connected to Heart Problems?
According to the American Heart Association, treatments for childhood cancer can sometimes cause long-term heart issues, known as cardiotoxicity. It is damage to the heart from any medical treatment. The young cardiovascular system is especially vulnerable to powerful therapeutic agents used in the treatment of children with cancer.
The link is about the interaction of some treatments and the heart tissue, explains Dr Varshney. A drug used in the treatment can directly damage the cells of the heart muscle, making the heart weaker over time and causing heart failure.
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If the radiotherapy treatment is directed to, or close to, the heart, it can lead to damage of the heart valves, blood vessels or lining around the heart (pericardium).
The danger, of course, depends on the amount of radiation received, age of the child at the time of the treatment, and whether the radiation was combined with other treatments that affect the heart, Dr Varshney added.
What Heart Problems Can Childhood Cancer Treatment Cause?
Dr Varshney lists specific problems that can occur from such treatments:
- Weakened heart muscle, known as cardiomyopathy, which reduces the heart's pumping efficiency
- Irregular heart rhythms, or arrhythmias
- Heart valve problems
- Coronary artery disease at a younger age than typical
- Pericardial issues, such as inflammation or thickening of the heart's lining
- Reduced exercise tolerance or breathlessness in daily life
Can These Heart Effects Show Up Later in Life?
Yes, says Dr Varshney. It's one of the more established late effects of childhood cancer treatment. Survivors should be watched after treatment for a small number of years, since heart complications can occur within a few years, to several decades after treatment.
This prolonged window of opportunity does not mean that a person is safe from heart problems after getting well. It simply means that it is equally important to be mindful of potential heart problems even after the initial window of time.
How Are Heart Problems From Childhood Cancer Treatment Managed?
Treatment will depend on the type of heart disease, with drugs used to help the heart function, control blood pressure or treat abnormal heart rhythms if any are identified, Dr Varshney explains. In general, management of this kind includes:
- Long-term survivorship care, which includes cardiac screening, including ECGs and echocardiograms.
- Drugs to control heart function, if necessary, such as heart failure and high blood pressure drugs
- Lifestyle changes such as weight control, regular exercise (as recommended by a cardiologist) and abstaining from smoking
- If there are any symptoms or abnormal test results, a referral should be made early, preferably to a cardiologist who is experienced in cardio-oncology.
- Further cardiac interventions in more advanced cases, guided by a cardiology specialist
Dr Varshney also notes that children at higher risk may require periodic echocardiograms even if they have no symptoms, so any changes can be detected early.
Why Ongoing Cardiac Monitoring Matters So Much
According to a 2025 study published in Cureus, diagnosing heart issues during cancer treatment requires careful medical evaluation. Treatments like chemotherapy and radiotherapy can lead to cardiac complications, including high blood pressure, heart muscle damage, and irregular heart rhythms.
Doctors use clinical assessments, imaging tests like echocardiograms, and blood tests to monitor cardiac health. In particular, blood testing for cardiac biomarkers, like Troponin-I and NT-proBNP, can be used to identify early heart damage, enabling timely intervention to prevent further harm to the heart during cancer treatment.
After cancer treatment stops, and scans are clear, it is easy to assume that the heart is in the clear as well. However, as Dr Varshney's advice suggests, many of the most important cardiac impacts only manifest themselves years later.
Conclusion
The treatment for childhood cancer may have a profound impact on the health of the child's heart, sometimes many years after the child was first diagnosed. Awareness of this risk and the ongoing commitment to regular cardiac screening throughout life will increase the likelihood of early detection of potential problems and their effective management before they start to impact the health of a survivor.
FAQ
1. Are there specific warning signs of heart problems that childhood cancer survivors should watch for as adults?
Yes, these symptoms, such as unusual tiredness, shortness of breath when doing normal activities, irregular heart sensations, swelling in the legs or ankles or discomfort in the chest, are all of concern and should be reported to the doctor, particularly if you have had chemotherapy or chest radiotherapy. These should not be taken for granted as being due to general tiredness or "old age" without appropriate cardiac assessment.2. Does the type of childhood cancer affect the level of heart-related risk later in life?
The type of cancer doesn't directly affect the risk of heart disease, but rather the type of treatment that's used to control the cancer. Irrespective of which type of cancer they were diagnosed with, survivors who received anthracycline chemotherapy or radiotherapy to the chest area have a higher chance of long-term heart complications than those who received chemotherapy or radiotherapy not affecting the heart area.
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Current Version
Jul 24, 2026 12:24 IST
Published By : Vivek Kumar
Reviewed By : Dr Ankur Nandan Varshney
