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How might having hyperlipidemia affect my cancer treatment??

While high levels of blood sugar or uncontrolled blood pressure can sometimes delay surgical procedures, there¡¯s no level of high cholesterol that would automatically disqualify you. Instead, what might preclude you from surgery is having chest pain that is heart-related.?

In those situations, we would need to postpone surgery until we could do more testing. We¡¯d need to make sure you weren¡¯t having an active heart attack or have blockages to the arteries that may put you at risk for heart-related complications during surgery.?

Patients receiving the following treatments should also be very mindful of hyperlipidemia:??

Chemotherapy involving anthracycline drugs

Doxorubicin is a chemotherapy agent from the anthracycline class of drugs. It is often used to treat breast cancer,?leukemia,?lymphoma?and?sarcoma. Sometimes, this medication can weaken the heart muscle or cause it not to pump normally. So, controlling hyperlipidemia before starting doxorubicin may reduce the risk of anthracycline-associated cardiac dysfunction.?

Radiation therapy for head and neck cancers

Radiation therapy?(especially to the chest, head and neck) can accelerate atherosclerosis. So, lowering patients¡¯ cholesterol as much as possible before they start receiving radiation therapy can reduce that risk.??

Hormone therapy for prostate cancer

When?prostate cancer?is hormone-driven, patients may undergo a type of therapy called androgen deprivation. This starves the prostate cancer of the chemical signals it needs to thrive.??

But depriving the body of these hormones can also accelerate?metabolic syndrome, which increases both cholesterol levels and the risk of stroke and heart disease. So, we¡¯re often more aggressive in lowering LDL in patients on androgen deprivation therapy. Optimal LDL levels are below 100 mg/dL for the average person. With our patients on androgen deprivation therapy, we often aim for 70 mg/dL or lower.??

Is there any known link between high cholesterol and cancer?

?associated higher LDL levels with an increased risk of breast cancer. And some laboratory research shows that hyperlipidemia can play a role in tumor cell growth because it increases a cancer cell¡¯s ability to divide, spread, and create its own blood supply. But we don¡¯t have any studies in humans to support this yet.??

The most robust evidence links some?cancer treatments?¡ª not the malignancies themselves ¡ª to the development of hyperlipidemia. So, for now, we just consider hyperlipidemia a shared?risk factor?for both cancer and atherosclerosis.??

Which cancer treatments are associated with hyperlipidemia?

Asparaginase

This is a chemotherapy drug used to treat?acute lymphocytic leukemia. It is known to cause very high levels of triglycerides and increase the risk of pancreatitis.?

Radiation therapy

This can contribute to abnormal lipid levels in survivors, especially when it induces growth hormone deficiency. That¡¯s why the American Heart Association recommends regular lipid monitoring in?childhood cancer survivors.?

Steroids

Frequently used in?cancer treatment,?steroids?are associated with elevated triglycerides and LDL.??

Targeted therapies??

• Rapamycin (mTOR) inhibitors?(e.g., everolimus, sirolimus) are associated with significant increases in triglycerides and LDL.?
• Vascular endothelial growth factor receptor (VEGFR) inhibitors: Multitargeted VEGFR-TKIs especially are associated with a higher risk of hyperlipidemia, though the risk is less than with mTOR inhibitors.?

Is there any way to prevent hyperlipidemia?

Yes. We usually start by suggesting certain lifestyle changes first. These include:?

Diet

We encourage patients to eat more?fiber. Usually, that means following a?heart-healthy diet, rich in leafy green vegetables,?grains,?nuts?and?seeds. We also advise them to avoid?red?and?processed meats, and to choose healthier protein options, such as chicken, fish and tofu. The goal is to reduce their daily consumption of certain fats to:?

• saturated fat: no more than 13 g?
• cholesterol: 300 mg or less?
• trans fats: 0 g (ideally)?

Exercise

Aim for 150 minutes of?moderate intensity exercise?or 75 minutes of vigorous exercise per week.??

Tobacco

¶Ù´Ç²Ô¡¯³Ù?smoke or use other tobacco products. If you do,?quit now. Smoking has been proven to lower HDL levels, which you don¡¯t want. It also significantly increases your risk of heart disease.? ?

Stress

Find ways to reduce stress whenever you can, whether that¡¯s through?yoga,?meditation, or?some other method. Stress is known to negatively impact lipid levels.??

If these methods don¡¯t work ¡ª or don¡¯t work well enough to lower your cholesterol levels sufficiently ¡ª we can try one or more of the following medications:??

• Statins: These stop cholesterol production in the liver.?
• Ezetimibe: This drug prevents the absorption of cholesterol by the gut.?
• PCSK-9 inhibitors: These block a protein that destroys LDL receptors, which results in more active receptors in the liver, clearing more LDL from the bloodstream.?

What¡¯s the one thing you should know about hyperlipidemia and cancer?

High cholesterol is one area of your health that you have some control over. So, don¡¯t be afraid to ask your doctor to check your cholesterol levels, or say, ¡°How is this treatment going to affect my heart?¡±??

?or call 1-877-632-6789.