Editor’s note: This is the first of two articles focusing on survivorship for people with cancer. The second article will focus on wellness aspects, such as diet, fitness, emotional support and mental health.

While more Americans than ever before are living full and active lives after a cancer diagnosis, patients still must navigate treatments, medications and appointments as cancer survivors.

According to the National Cancer Institute at the National Institutes of Health, about 5.4% of the U.S. population, or an estimated 18 million Americans, are cancer survivors – numbers that are expected to increase by 24%, to 22.5 million, by 2032. And over the next 10 years, the five-year survival rate after cancer diagnosis is expected to increase by 30%.

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“One of the most rewarding things about our work is seeing the amazing resilience of the human spirit in our patients who are dealing with cancer,” said UCHealth’s Dr. Lavanya Kondapalli, associate professor of medicine in the Division of Cardiology and director of Cardio-Oncology at the University of Colorado School of Medicine.

Two primary factors account for the growing number of survivors: better screening and better treatment. Accompanying that is a growing realization that patients need to stay focused on other potential health issues that could arise during their cancer treatment, including cardiovascular needs.

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“This is especially important,” Kondapalli said, “since heart disease is a concern for so many Americans, and because certain cancer treatments can cause cardiac complications that should not be ignored.”

Key role of heart health for survivors

“The vast majority of Americans are going to get some type of heart diagnosis in their lifetime,” said Kondapalli. “As we treat patients with cancer, we also want to be good stewards of cardiovascular health for them.”

As a cardiologist with expertise in managing heart complications for patients going through cancer treatment as well as survivors of childhood cancer, Kondapalli sees patients who have had heart issues before, during or after a cancer diagnosis.

Some cancer treatments can cause cardiac toxicity, so it’s important to stay on top of appointments, in addition to oncology visits. For instance, women with breast cancer can experience side effects from chemotherapy, immunotherapy and hormone therapy that can affect the heart. Also, radiation to the left breast can be a risk factor for future heart disease.

“When we think about breast cancer, the survivor rate is high, which is wonderful, and there are a lot of treatment options,” said Kondapalli. “But some can have side effects either at the time of treatment, or long term showing up later in life, which is why we think being aggressive about cardiovascular health is one of the best tools we have to decrease the potential cardiac side effects of breast cancer treatment.”

Don’t forget your annual check up

In the past, there was more of a tendency to focus on just fighting the cancer. That has changed as physicians continue to treat all conditions a cancer survivor might be experiencing.

“It is important that you keep your appointment with your primary care doctor during breast cancer treatments, as well as seeing a cardiologist annually for follow up if it’s recommended,” said Kondapalli.

Taking ownership of your health care during cancer treatments and beyond includes keeping an eye on other health issues such as high blood pressure, cholesterol and diabetes, all of which can change for better or worse.

“These diagnoses don’t just get pushed aside,” she said. “Because breast cancer can occur at many different ages, some women might also be dealing with other medical diagnoses in addition to cancer.’’

There are concerns that survivors of childhood cancer between the ages of 18-35 may not be as diligent as they need to be about seeing primary care providers.

“If you got treated for cancer before the age of 18, get checked by a cardiologist annually,” recommends Kondapalli.

The best advice she gives to her patients dealing with cancer is also one she preaches in general.

“Take the best care of yourself,” she said. “We know that cardiovascular health is so important to overall health — not just for cancer survivors, but for everyone.”

Mary Gay Broderick writes for UCHealth. She can be reached at marygaybroderick@comcast.net.