How cancer drugs can hurt the heart

When we think about medicine, we usually hope it will help us feel better. But sometimes, even important medicines like cancer treatments can have unwanted side effects. One cancer drug, doxorubicin, is powerful at fighting tumors, but it can also cause problems for the heart. Scientists have been working to understand exactly how this happens and how we might stop it. Let’s explore what they have discovered and what it could mean for people receiving cancer treatment.

What is doxorubicin and how does it work?

Doxorubicin is a medicine that doctors use to treat many types of cancer. It works by attacking the DNA inside cancer cells, stopping them from growing and spreading. But doxorubicin can also affect healthy cells, especially the cells in our hearts, leading to a problem known as cardiotoxicity. This means the drug can make the heart weaker or even cause heart failure over time. Scientists have spent years trying to figure out why this happens so they can make cancer treatment safer.

The surprising role of neutrophil extracellular traps (NETs)

Recently, scientists made a discovery about something called neutrophil extracellular traps, or NETs for short. Neutrophils are a type of white blood cell that help protect us from germs. When they detect danger, they can release sticky webs made of DNA, called NETs, to trap and kill invaders. However, these sticky DNA traps can sometimes cause damage to our own bodies.

A new study in Nature Cancer found that when people take doxorubicin, it can trigger the release of NETs. These NETs release DNA outside the cells, which then interacts with heart cells in a harmful way. The key player in this process is a sensor on heart cells called CCDC25.

How NET DNA and CCDC25 harm the heart

The CCDC25 sensor sits on the outside of heart cells. When the DNA from NETs touches CCDC25, it sets off a chain reaction inside the heart cell. This reaction causes the cell to make more reactive oxygen species, which are harmful molecules that can damage cells. It also switches on something called autophagy, a process where cells clean up and recycle their parts. Too much autophagy, however, can make heart cells not work as well.

All of this adds up to weaker heart function for people taking doxorubicin. But there’s some good news: the scientists found that blocking CCDC25 can protect the heart from this damage, while still letting doxorubicin fight cancer effectively. This means researchers may be able to develop new strategies to keep cancer patients’ hearts healthy during treatment.

Other ways doxorubicin affects the heart

This isn’t the only way doxorubicin can hurt the heart. Previous research, like the review in Nature Reviews Cardiology, has looked at other reasons doxorubicin is risky for the heart, including how it affects the tiny blood vessels and molecular pathways inside our heart. Another study showed that NETs can make heart injuries worse after a heart attack by causing inflammation and more damage (see this paper). Understanding all these pathways helps doctors search for better ways to protect the heart while treating cancer.

What it means for patients

If you or someone you know is getting doxorubicin as part of cancer treatment, this new science gives hope for safer therapies in the future. Doctors are learning more about how the body reacts to treatments at the cellular level, and how to prevent side effects like heart damage. This is especially important because cancer survivors are living longer, so keeping their hearts healthy is a top priority.

For people interested in how health information and new treatments come together, health AI is helping doctors spot patterns and predict who might be at risk for side effects. To learn more about how your health data is used and protected, check out why your health data is valuable and important and also see how to keep your health data private with AI for simple ways to stay safe in today’s digital healthcare world.

The future of safer cancer treatment

So, what’s next? Thanks to these discoveries, researchers are exploring ways to block the CCDC25 sensor or prevent harmful NETs from forming in the first place (see more details here). This could mean that, in the future, patients can get powerful cancer drugs like doxorubicin without as much worry about heart problems. As science advances, health AI and careful research will keep making cancer care safer and more effective for everyone.