Survival rates of those with cardiovascular disease have increased hugely over the last twenty-years, coinciding with an increase in public knowledge of the important lifestyle factors and heart health. We all know that regular health check-ups are important for a smooth recovery after a heart attack to monitor cardiovascular health and to catch potential complications early. At these appointments, doctors will typically monitor blood pressure, cholesterol, and heart rate to check for any abnormalities. However, an unexpected pattern has recently emerged during these visits: those who have suffered a heart attack are more likely to be diagnosed with cancer later on.
Initially, this was believed to be a coincidence (after all, heart disease and cancer are the two leading causes of death worldwide), or due to the fact that they share many risk factors like smoking, poor diet, and lack of exercise. However, scientists working in Tel Aviv University and the Sheba Medical Center in Israel have revealed the unsettling truth that those who have survived a heart attack are more likely to develop cancer later on in life.
A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow to the heart is blocked, reducing the amount of oxygen the heart receives. This restriction of oxygen damages the heart tissue, affecting its ability to beat properly and pump blood around the rest of the body. Recent research has shown that heart attack survivors have roughly double the amount of small extracellular vesicles (sEVs) in their blood compared to healthy individuals. These molecules are thought to act as messengers, travelling through the body to help communicate between the heart and other organs, orchestrating a systemic response to injury as part of the body’s natural attempt to heal. However, they often carry signals that promote tumour growth, encouraging cells to divide uncontrollably, and increase the chance of cancer development.
In a recent study, a team of researchers, led by Dr Jonathan Leor, isolated cardiac stem cells, (which are known to help repair damaged heart tissue), from mice that had experienced a heart attack and those who had not (the control group). Their findings were striking. In the post-heart attack group, levels of osteopontin, a protein known to promote tumour growth, was more than five times higher than the control group. Similar increases were seen in several other cancer-promoting molecules. This suggests that following a heart attack, the heart releases a cascade of factors that creates a body-wide environment that is more supportive of cancer cell survival and growth.
This discovery has revealed that the effects of a heart attack don’t stop at the heart! They ripple through the body via molecular messengers, causing a shift in equilibrium which can enhance cancer development. However, there is good news. Researchers are now developing novel ways to measure biological markers to detect cancer earlier, as well as more powerful treatment options. These methods are all possible due to an increase in cancer research funding, allowing survival rates to improve.
Ultimately, these findings have led to a paradigm shift in our understanding of cancer progression. Heart disease and cancer, once viewed as two separate illnesses, are now seen differently. With this broader outlook, doctors will have to be on the lookout for additional warning signs, and a greater emphasis could be placed on cancer risk in heart attack survivors. This could also lead to a stronger focus on preventative care, helping to address the links between these two major threats to health.
Article written by Izzy McMeeking, a 4th year Biochemistry student at The University of Edinburgh. She is interested in the molecular mechanisms of cancer development and all the possible ways we can prevent its spread.
Article edited by Eleanor Stamp, a Neuroscience PhD student at the Institute of Genetics and Cancer, University of Edinburgh, and an Online News Editor for EUSci.
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