Risks of Stroke in Young Cancer Patients

Introduction

Cancer makes the body amenable to various other problems or disorders in the body. The body becomes prey to multiple disorders either due to the cancer treatment or due to the disease itself. Even with many advancements in cancer therapy, the treatment is still a ghastly one. Many studies and observations are being conducted while still trying to associate a relationship between cancer and stroke (brain damage due to lack of blood supply). There is an increase in the number of deaths from cancer-associated strokes than unrelated isolated strokes. This is an observation and a reality as well. The proof that cancer causes stroke in young adults is yet to be derived.

Does Cancer Cause Stroke?

Many studies have provided a review that the risk of stroke is increased after the diagnosis of cancer. This risk has, surprisingly, turned multifold in young individuals. It is observed that most cancer patients did not die due to cancer but died due to heart and vascular problems. Many cancers, like breast and prostate cancers, have led to cardiovascular death in patients younger than 35 years.

Researchers have studied the data obtained by surveillance, epidemiology, and results (SEER) only to know the prevalence of cardiovascular deaths in cancer patients. It is observed that most of the cardiovascular deaths that occurred in cancer patients were from:

• Heart Disease: Any disease or condition related to the heart or its blood vessels is called heart disease. The common heart disease is coronary artery disease (CAD), which can be the reason for heart attack.

• High Blood Pressure: It is also called hypertension, which occurs when the blood flow pressure against the walls of blood vessels is high, 140/90 mm of Hg (millimeters of mercury) or higher.

• Cerebrovascular Disease: A disease in which the blood flow and blood vessels of the brain are affected.

• Blocked Arteries: Arteries are the blood vessels that deliver healthy blood from the heart to the body's tissues. When the walls of these arteries become thick due to plaque formation, the vessel narrows down, leading to partial or complete blockage.

• Damaged Aorta: The aorta is the main artery that carries blood from the heart to various parts of the body. When the inner wall of the aorta is damaged, the flow of blood can increase, causing an aortic tear to grow and serious implications.

Most deaths in patients with breast cancer occur due to cardiovascular conditions and not due to cancer itself.

How Can Cancer Cause Stroke?

Stroke can be the result of various factors in cancer patients. A few of these are as follows:

• Type of cancer.

• Duration of cancer.

• Type of treatments used for curing cancer.

• Age of the patient.

• Concomitant illness.

• Smoking.

How Cancer-Associated Stroke Is Detected in Young Cancer Patients?

Detection of cancer-associated stroke is done in the following ways:

• Medical History: This includes assessing risk factors, such as atrial fibrillation, diabetes, and hypertension.

• Imaging Tests: These are done to identify signs of stroke and any cardiac abnormalities through computed tomography (CT) scan and magnetic resonance imaging (MRI).

• Biomarkers: Inflammatory markers (such as C-reactive protein, plasma viscosity, or erythrocyte sedimentation rate) and D-dimer (blood test to detect blood-clotting problems) levels are also measured for detecting stroke.

How to Manage Stroke in Young Cancer Patients?

Many more studies need to be conducted to come to the exact conclusion about why and how strokes occur in young cancer patients. Lifestyle and food habits can be considered attributable to stroke. Nevertheless, the causal association is yet to be established. While treating a cancer patient, an oncologist is more worried, or the concentration is directed toward how to treat cancer. Medicine has reached a point where the deaths due to cancer have reduced comparatively, which is due to advancements in cancer therapies. A multidisciplinary team has to be formed while treating cancer patients that would focus on treatment delivery as well as the outcome.

There are no specific guidelines to predict or prevent stroke in cancer patients. Hence, the doctors must treat cancer as a risk factor for stroke and then deliver the cancer treatment.

Who Is at Risk of Stroke Among Cancer Patients?

It is observed that most cardiovascular deaths in cancer patients occur either in high-risk or aggressive cancers, cancer survivors, or those who are in the face of remission. This group of patients is considered high-risk patients for cardiovascular death. Young head and neck cancer patients are at more risk of stroke. A larger number of cancer patients are observed to suffer from conditions like stroke, aneurysm (weak or bulged area in the artery), high blood pressure, and damage to blood vessels. The reasons why the patients suffer from these abnormalities once they are diagnosed with cancer are due to other illnesses or ailments such as lung dysfunction, kidney failure, and aggressive cancer treatments.

What Type of Cancers Cause Stroke in Young Patients?

The types of cancers that predispose a patient to stroke are:

• Breast Cancer: It is a cancer of the breast in which the breast cells grow abnormally. It starts with a single breast, which later on involves another breast as well.

• Cancer of the Larynx: When the cells in the larynx, also called the voice box, undergo malignant transformation, they develop into cancer in the larynx.

• Skin Cancer: Cells of the skin undergo abnormal multiplication and accumulation, forming tumor masses that form skin cancer. This may be due to exposure to the sun, hazardous chemicals, or an autoimmune disease.

• Hodgkin’s Lymphoma: It is a cancer of the lymphatic system that includes lymph nodes and lymphatic vessels spreading throughout the body.

• Prostate Cancer: It is the cancer of the prostate gland. In males, this gland produces the seminal fluid that carries sperm. Hence, it is most commonly found in males.

• Thyroid Cancer: The abnormal multiplication of cells occurs in the thyroid tissues, causing thyroid cancer.

What Are the Other Effects of Cancer in Young Adults?

• Heart problems.

• Lung disorders.

• Fertility issues.

• Auditory impairments (loss of hearing).

• Ocular abnormalities.

• Kidney problems.

• Generalized edema (swelling caused by fluid buildup).

• Hormone deficiencies.

What Are the Preventions for Stroke in Young Cancer Patients?

There are no specific measures to prevent stroke in young adults. Some of the preventions may include:

• Regulation of predisposing factors, such as diabetes mellitus, high blood pressure, atrial fibrillation (rapid or irregular heart rhythm), hyperlipidemia (high levels of lipids or fats), smoking, and carotid disease in cancer patients is crucial.

• Limit alcohol consumption.

• Choose a healthy lifestyle, meals, and drinks.

• Regular physical exercise.

• Healthy weight management.

Conclusion:

Active cancer carries a higher risk in young adults for stroke. Though cancer has a poor prognosis, the risk factors must be kept in mind while delivering the treatment. Researchers hold very little information about the cause of stroke in young cancer patients. Advanced and aggressive cancers carry a higher risk for stroke in patients, whereas cancer treatment itself carries a risk for stroke in young patients.