The Overlapping World of Cancer and Afib: What We Know and Why It Matters

Most people think of cancer and heart problems as two separate battles. But emerging research is revealing a surprising connection between the two, especially when it comes to atrial fibrillation (Afib). For people with cancer, the risk of developing Afib is much higher than in the general population. Inflammation caused by tumors and the side effects of anti-cancer therapies can directly impact the heart’s rhythm. People with Afib may also face a greater risk of developing certain cancers. By understanding this two-way relationship, patients and healthcare providers can better manage both conditions and improve outcomes for those facing the dual challenge of cancer and Afib.

Key Points:

Cancer patients: why are they at higher risk of Afib?

How systemic inflammation contributes to Afib

Though initially the connection between cancer and Afib might seem unintuitive, once we consider the more intricate processes at work in our bodies the question becomes more complicated.

Systemic inflammation, a term denoting aggressive body-wide inflammation, is triggered by conditions such as cancer and results in sustained tissue damage, damage-induced cellular proliferation, and tissue repair. Chronic inflammation creates a favourable environment for tumor cell survival and can be a result of different forms of stress, carcinogens, viruses or bacteria. Common markers promoting tumorigenesis include interleukins, reactive oxygen species, tumor necrosis factor-alpha and chemokines which can exacerbate DNA damage. This inflammation can affect the heart’s rhythms through overexpression of the aforementioned inflammatory particles. Chronic systemic inflammation and increase in inflammatory proteins have been linked to cardiomyocyte apoptosis and atrial remodelling, which contribute to Afib development.

Anti-cancer therapies cause cardiac tissue damage 

Secondly cancer treatments themselves, such as chemotherapy, targeted therapies and radiation can cause damage to heart tissue contributing to a weakened heart. These treatments contribute to cardiotoxicity which disrupts normal cardiac function. Anti-cancer therapies have been linked to mitochondrial dysfunction, disrupted Ca2+ handling, increased cell death, increased fibrosis, and cardiac inflammation. All of which contribute towards Afib development as well as worsened cardiac health outcomes.

Shared risk factors between cancer and Afib

Cancer and atrial fibrillation share many risk factors such as age, smoking, diabetes, alcohol abuse, and obesity so it is not surprising that both conditions arise in the same populations. These shared risk factors as well as these conditions’ proposed shared biology mean that Afib and cancer are connected on many different levels.

How does Afib affect cancer prognosis?

Since this connection between Afib and cancer is a two-way street we should also examine how Afib affects the prognosis of cancer patients. A study using Dutch nationwide statistics found that not only was there a strong association between Afib and cancer but having Afib and cancer together often leads to higher mortality and complication rates among patients. Additionally it was found that individuals with cancers of the oesophagus, lung, stomach, myeloma, and lymphoma faced the highest risk of developing Afib. Developing concurrent conditions possess treatment dilemmas and results in patients having worsened outcomes.

Clinical and patient perspectives

With the increasing prevalence of both cancer and Afib, integrative care models are more important than ever. As the coexistence of both atrial fibrillation and cancer were associated with poorer survival, the question of how to manage these conditions concurrently should be posed. It is extremely relevant for patients to be informed about their risk factors and attempt to minimize them. Additionally cancer patients might consider placing increased emphasis on cardiovascular health and vice versa. Personalized care is important in order to control for the different health landscapes possessed by individuals.

Cancer and Afib are connected in complex and bidirectional ways and their association is no coincidence as these two conditions share common biological pathways and risk factors. Inorder to fully understand this relationship, more research is needed in order to understand the mechanisms at play. This could allow for improved survival rates of both Afib and cancer patients and enhance their quality of life.