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Cardiovascular and Cancer Comorbidities

Understanding interactions between cancer and cardiovascular disease

Recent studies have shown that advances in treatment have led to improved survival of cancer patients but have also increased mortality due to treatment side effects. Cardiovascular diseases are the most frequent side effects1. This is the result of cardiotoxicity, which involves direct effects of cancer treatment on the heart function. There is a growing concern that side effects may lead to premature morbidity and death among cancer survivors2.

Within five years of diagnosis people treated for lymphoma or breast cancer are three times as likely to develop heart failure, as people who never had cancer. Heart failure is the final stage of most cardiovascular diseases. It is extremely debilitating and deadly, and no effective treatment, except heart transplantation, is currently available to cure it.

The interaction between cancer and chronic heart failure is a massive psychological burden for patients. Equally, an increasing incidence of cancer in patients with heart disease has been identified, clearly showing the need to avoid tackling diseases in a siloed approach. 

Due to the significant economic impact on the EU’s healthcare systems, ESC Advocacy, working with the support and expertise of the ESC Cardio-Oncology Council, leverages the professionals' voice to reach EU and national decision-makers.  Read more on the ESC Cardio-Oncology Council activities.

Shaping the EU’s Beating Cancer Plan

ESC statement on cardiovascular cancer comorbidities

The ESC contributed to the shaping of the EU’s 'Beating Cancer Plan', responding to EU consultations and providing scientific input to EU decision-makers. The ESC has been arguing that to successfully achieve the goal of reducing the burden of Europe’s second-biggest killer after cardiovascular disease, a more integrated and holistic approach on comorbidities is needed.

The ESC called on the European Commission and the European Parliament to:

  • recognise cancer comorbidities as a central component of the EU Cancer Plan and cardiovascular disease as the most frequent comorbidity
  • involve the cardiovascular community in the development and implementation of the EU Cancer Plan
  • support research on cancer and cardiovascular comorbidities under the EU Cancer Mission

Joint statement on cancer-related complications and comorbidities

Europe’s Beating Cancer Plan was officially launched on 4 February 2021. The ESC is actively engaged with cancer organisations such as the European Cancer Organisation and the European Patient Coalition, advocating for greater focus on the cardiovascular disease being the first side effect of cancer treatment. 

Joint statement with the European Cancer Patient Coalition

Cardiovascular disease should be better featured in the Plan, is the message put forward in a recent letter sent to DG Sante.

Joint letter with the European Cancer Organisation

The ESC together with the European Cancer Patient Coalition (ECPC) and other medical associations have launched a White Paper on cancer comorbidities during the European Cancer Week. As Europe’s Beating Cancer Plan is now in its implementation phase, it is crucial to continue raising the voice on the importance of more policy and research action around cancer and cardiovascular disease complications. 

Joint White Paper on cancer and cardiovascular disease complications

Case Study

Listen to the story of ESC Patient Forum member, Kreena Dhiman, who was diagnosed with breast cancer at the age of 33, and, as a result of the cardio-toxicity of the chemotherapy, developed severe heart failure.


  1. ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines, European Heart Journal (2016)
  2. Cancer diagnosis in patients with heart failure: epidemiology, clinical implications and gaps in knowledge, European Journal of Heart Failure (2018)
  3. Higher risk of heart failure seen in some cancers, National Cancer Institute (2018)