Other causes of cardiovascular disease after cancer therapy
Lipid Disorders and Metabolic Syndrome
Metabolic syndrome is a combination of some or all of the following problems:
- Central obesity
- Insulin resistance or glucose intolerance
Associated with an increased risk of cardiovascular disease
Increased risk of metabolic syndrome:
- After treatment for ALL (especially if this included cranial RT)
- After treatment for brain tumors (again associated with cranial RT)
- Female gender
- Steroid therapy
- Genetic predisposition
Screening for metabolic syndrome:
- Periodic determination of the following blood work is recommended
- serum triglycerides
- low-density lipoprotein
- high-density lipoprotein cholesterol
- serum glucose
Growth hormone deficiency due to RT-induced damage to the hypothalamic-pituitary axis increases the risk of cardiac disease and is associated with:
- abnormalities of metabolism and body composition
- abnormal bone mineralization
- impaired cardiac muscle function
- central obesity
- unfavorable lipid profile.
Long-term survivors of BMT (hematopoietic cell transplantation) are at increased risk of developing:
- insulin resistance
- type 2 diabetes
- Pancreatic dysfunction after BMT may occur in the setting of normal BMI (body mass index).
Long-term survivors of Wilms tumor
- At increased risk of hypertension because of previous nephrectomy (common).
- Type 2 diabetes mellitus has also been reported after abdominal RT for Wilms tumor (rare).