Echocardiogram procedures during chemotherapy

Hi there, I am 3 months into chemotherapy treatment, just had my first EC (yesterday) after 4 x Abraxane. I had an ECG 29th June where I was told I’d need them throughout treatment to check my heart was okay (all was fine in first ECG). I chased this up on my last catchup call with oncology nurse mid November who said she’d refer me for one. Then chased again via support worker last week. When I arrived for chemo yesterday morning there was clearly some kind of issue I could tell as various nurses together looking over at me then they told me my ECG was out of date so they weren’t meant to treat me really and were just trying to get hold of my oncologist. Anyway, the ANP intervened and they did something else on me (not an ECG…lots of wires…to check on my heart) - was fine and said I’d need a full ECG before my next treatment.
I chased this up with my oncology nurse today & she’s said my oncologist has confirmed I don’t need an ECG, it’s not relevant to the treatment I’m on (altho I’m almost certain EC chemotherapy does have a negative effect on the heart). And I am just wondering why this is? The negative side of my brain says it’s due to cost. I’m anxious about it because I am a runner and have been running through treatment (albeit slower & slower) & have noticed my HR getting higher & higher during exercise! My nurse said the kind of heart issues that would cause me to have an adverse heart event during exercise wouldn’t show up on an echocardiogram anyway?
Keen to get a second opinion from the nurses on this if possible

Hi sunshineandunicorns

Thank you for posting.

It’s reassuring that your ECG at the end of June was ok. Although your oncologist has said you don’t need an ECG now, it’s understandable that you have concerns as you’ve noticed a change to your heart rate when you exercise.

Some chemotherapy drugs can affect how the heart works. Abraxane can affect heart rate which is why people are monitored during treatment. Tests may be done before, during and after treatment depending on the protocols in your chemotherapy unit. How often you have tests such as an ECG depends on the type of treatment and whether you already have heart problems.

Heart changes are a less common side effect of EC chemotherapy but people usually have a hear(cardiac) function test done before starting treatment to check that the heart is working normally. I wonder if this is the test that the ANP did before you had your first EC treatment.

If you have not already done so, we would suggest you ask for an appointment with your oncologist to talk this through. Your breast care nurse may be able to arrange this. Your treatment team are best placed to discuss this with you as they have all the information about your individual situation. It is also an opportunity for you to share your concerns about the changes to your heart rate that you have noticed during exercise.

If you still have concerns after discussing this with your treatment team, you may want to consider seeking a second opinion. You can talk to your GP or treatment team if you feel a second opinion would be helpful for you. They can refer you to another NHS team or a particular doctor. Some people choose to pay for a second opinion from a private doctor. Seeing a specialist for a second opinion usually involves going to a different hospital for that appointment. You may be asked if you have a particular hospital (or doctor) you would like to see for a second opinion.

We have a variety of support services, which may be of interest to you, both online and face to face. For more details about all of these services, please see the information on the link.

You are welcome to call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to more support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001).

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Best wishes

Eve

Breast Care Nurse

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