Even though I was treated to live, February 7, 13:36
A woman with breast cancer.
Her surgery was successful, and her chemo treatment was going well.
Unstoppable palpitations and shortness of breath...
It wasn't until four months later that she felt the difference.
The anti-cancer drug that was supposed to save her life had seriously damaged her heart.
It should have been avoided.
(Yokohama Broadcasting Station Reporter Yu Furuichi)
Successful cancer surgery
My name is Aya Muramoto (48) and I live in Hokuto City, Yamanashi Prefecture.
She lives in a log house built at the foot of Mt. Yatsugatake with her husband, Mayo (43), who works at a local hotel, and her dog Rei.
Originally from Saitama Prefecture, Muramoto moved to Hokuto City 14 years ago (2009).
While working at a tourist facility, she lived a life of going trekking on her days off and married her colleague Mayo.
In 2018, two years after we got married, I was diagnosed with breast cancer at a city checkup.
At "Stage 2", metastasis was seen in the lymph nodes under the arm.
The surgery was successful, and the course of anticancer drug treatment, which was started to prevent recurrence, has been going well.
Four months after the operation, when the treatment was about to end, I began to feel something strange in my body.
Ms. Muramoto:
“I could feel my pulse getting faster before I went to bed at night. I thought this would calm down once the medicine was over."
only heart transplant
She visited a hospital because her symptoms did not subside.
It was found that her heart function was severely degraded and she was rushed to the hospital.
I had severe heart failure.
I was transferred to a hospital where I could receive more advanced treatment, but my condition gradually deteriorated.
I underwent surgery to implant a ventricular assist device to help my heart function.
My doctor told me that I needed a heart transplant.
Muramoto:
“I only had the image that heart failure was just before death, so I wondered if I would die.
With the help of the artificial heart, I was able to carry out my daily activities such as walking my dog and doing housework.
Muramoto always wears a waist pouch.
It contains a battery for an auxiliary artificial heart and weighs 2 kg.
As a general rule, 24-hour attendance is required in case there is a problem with the device, and strenuous exercise and driving are not permitted.
Muramoto's hobby is trekking.
She wanted to walk in the mountains with her, so she gave snowshoes to her husband Mahiro for Christmas just before her emergency hospitalization.
It's stored away, unused.
Mr. Muramoto:
“Driving is prohibited, I can’t go to work even if I want to, and I can’t even go to a nearby convenience store by myself. I can't do anything because I was looking forward to going camping with my dog, climbing mountains, etc. I wanted to have a life where I could enjoy life in Yatsugatake. hey"
Anticancer drug was the cause
Muramoto's diagnosis is "drug-induced cardiomyopathy."
The side effects of anticancer drugs are thought to be the cause.
Anticancer drugs called "anthracyclines" were used for treatment.
Although it is an old drug that has been used for 48 years, it is highly effective in treating breast cancer and blood cancer, and is still used today.
Sales have doubled over the past decade as the number of cancer patients increases.
It kills cancer cells, but it also attacks heart muscle cells.
There are 100,000 new cases of breast cancer diagnosed each year, many of which use this drug.
Approximately 10% of treated patients develop impaired cardiac function, and some develop severe cardiomyopathy.
It is difficult to treat and only 50% of people who develop it survive five years.
I could have prevented it
Drugs exist to prevent this cardiomyopathy.
The drug dexrazoxane has been used in the United States for 28 years, and is also used in Europe, China, and South Korea.
However, in Japan, it is not approved for use to prevent cardiomyopathy.
It has been pointed out that there was a lack of cooperation between doctors who treat cancer and doctors who treat hearts.
There is little information sharing with each other, and the problem of side effects has been overlooked.
In 2017, Japanese oncology and cardiology specialists jointly established the Japanese Society of Oncology and Cardiology.
It wasn't until last year that I submitted a request to the Ministry of Health, Labor and Welfare for permission to use drugs to prevent cardiomyopathy.
Clinical trials may be required, which are expected to take at least several years.
Mr. Muramoto is currently going to the hospital, waiting for five years since his cancer surgery.
This is because the condition for receiving a heart transplant is that the cancer has not recurred for five years.
There are about 900 people on the waiting list for heart transplants in Japan, and less than 100 transplants are performed annually.
My doctor told me that it would take at least 6 years to get a transplant.
Ms. Muramoto:
“It is really frustrating that this happened even though I had to undergo treatment in order to live. We have absolutely no intention of blaming doctors or hospitals. If there is a drug to prevent cardiomyopathy, I would like to try it
. I think it's a very good thing. But I think we need a system that doesn't miss it."
At least early detection and treatment
Severe cardiac side effects of anthracycline anticancer drugs.
Efforts are underway to detect it early and prevent it from getting worse, even if it is not possible to use drugs to prevent it.
At the Niigata Prefectural Cancer Center Niigata Hospital in Niigata City, two to three patients treated with anthracycline anticancer drugs are transported by ambulance due to severe heart failure each year.
Heart failure is a disease that is difficult to notice, and it is difficult to detect it early unless you are a cardiologist. is that there are many
Dr. Yuji Okura, a cardiologist, recommends that patients undergo an examination once a year to detect heart failure at an early stage.
However, of the more than 1,000 people who received this anticancer drug treatment in the year to March 2021, 27.1% were tested.
Dr. Yuji Okura, Niigata Cancer Center Niigata Hospital
"Even if you start heart treatment after the symptoms of heart failure have worsened, the heart will never return to its original state, and even if you can leave the hospital, your daily life will be greatly restricted. If we find any abnormalities early and start protecting the heart, we can expect some degree of recovery.”
Continuous follow-up of patients treated with anticancer drugs
Two years ago, Dr. Okura created a database of patients who had been treated with anthracycline anticancer drugs so that they could know when they were tested.
Every six months, she keeps her doctor up to date on the status of the tests and encourages them if necessary.
Also, every week, we gather clinical laboratory technologists and hold review meetings.
Check the ultrasound images of each patient.
The purpose is to prevent oversight of abnormalities by checking with multiple eyes.
Dr. Okura
: “Cancer doctors are very busy, so there is a current situation where they do not pay attention to side effects. It's a disease that shouldn't be waited for to come out.By getting regular blood tests and echocardiograms, we want to detect any abnormalities before heart function deteriorates."
Discovered just before heart failure
Kimiko Watanabe (70) from Niigata City was found to have a heart problem during these efforts.
Three years ago, she was treated for breast cancer with an anthracycline and a targeted drug called an anti-HER2 drug.
All of these drugs carry the risk of heart failure and should be used with caution.
In June two years ago, at the urging of Dr. Okura, the attending physician performed a blood test and found signs of heart failure.
Watanabe had no subjective symptoms at all.
She continued anticancer drug treatment while monitoring her heart condition, but her condition did not improve, and she temporarily stopped using anticancer drugs.
She started heart treatment.
Kimiko Watanabe:
"The numbers were so bad that the teacher said, 'You're standing on the edge of the cliff of the pond and you're about to fall.' I was told that they would like to help me now.
Never give up climbing or swimming
He started treatment early, and his progress has been good.
From spring, it is expected that mountaineering and sports, which are my hobbies, will be able to resume.
Kimiko Watanabe's interview:
"I've been told that I haven't fully recovered yet, so I really want to be careful. I want to sweat like this, and if there is a competition, I want to participate.”
From this spring, Dr. Okura plans to expand the initiative to family doctors in the region with the cooperation of the Niigata City Medical Association.
Cardiac Risk Continues to Rise
The number of anticancer drugs that require attention to side effects on the heart is increasing year by year.
According to Dr. Okura, there were 25 types of anti-cancer drugs listed as heart failure in the "Important Basic Precautions" of the package insert of the drug, but as of last month (January), there are 33 types. increased.
There is an increasing need to pay attention to the condition of the heart while treating cancer.
Dr. Okura
: “Although new drugs that are effective against cancer will continue to come out, unfortunately, there will also be some that have side effects on the heart. At the same time, it is important to create a system that allows cancer treatment to be continued.”
after the interview
An anti-cancer drug that was supposed to save her life ends up damaging her heart.
Patients are unaware of this, and even though there are drugs to prevent it, they cannot use it.
I felt that there were many patients who could have been saved.
A doctor's words left an impression on me: "Until now, heart failure caused by anticancer drugs has been dismissed as 'bad luck' or 'because of my constitution.'"
Breast cancer, cervical cancer, malignant lymphoma, and leukemia, for which anthracycline anticancer agents are often used, are cancers that occur relatively often in younger generations.
The younger generation is no different.
Ms. Muramoto, who responded to the interview, was in her 40s and developed cancer when she was in her prime.
Now that the five-year survival rate for cancer has exceeded 60%, it is becoming more important to find a balance between cancer treatment and heart protection.
Preventive measures, which until now were left up to the efforts of individual doctors, should be systematically carried out. At the same time, it is necessary to accurately inform the patients themselves of the possibility of side effects and have them pay more attention to their physical conditions. felt.
Reporter, Yokohama Broadcasting Station
Yu Furuichi Joined the station in
2010
After working at the Osaka Station and the Science and Culture Department, etc.