title: Vascular injury in cancer survivors.
abstract: With an increase in the number of patients surviving many years following successful cancer treatment, has come an improved understanding of the long-term effects of cancer therapy and its implications on future health. Premature cardiovascular disease is a significant cause of early morbidity and the leading non-cancer cause of death in this population. Chemotherapeutic agents and radiation therapy are known to be cardiotoxic. However, numerous vascular-related toxicities have also been observed among cancer survivors, such as myocardial ischemia, transient ischemic attacks, and stroke, suggesting a degree of chronic endothelial injury and dysfunction leading to premature atherosclerotic disease. Vascular health in cancer survivors may be further compromised by metabolic abnormalities such as obesity, insulin resistance, and dyslipidemias which have also been reported following cancer therapy. Furthermore, some survivors experience gonadal dysfunction and loss of potentially protective sex steroids or undergo hormonal therapies that induce additional metabolic abnormalities. The effects of cancer therapies upon the endothelial monolayer have not been fully explored. An understanding of potential injury to and dysfunction of the circulatory system among cancer survivors is essential for identifying preventive strategies and therapeutic targets.
authors.affiliation: Division of Cancer Survivorship, Department of Oncology, St Jude Children's Research Hospital, Mail Stop 735, 262 Danny Thomas Place, Memphis, TN 38105, USA. daniel.mulrooney@stjude.org
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Mulrooney
authors.forename: Anne H
authors.initials: AH
authors.lastname: Blaes
authors.forename: Daniel
authors.initials: D
authors.lastname: Duprez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D015897:Comorbidity; D004730:Endothelium, Vascular / Q000187:drug effects / Q000528:radiation effects; D004734:Energy Metabolism / Q000187:drug effects / Q000528:radiation effects; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D011379:Prognosis; D011832:Radiation Injuries / Q000209:etiology* / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents