cardiovascular-agents and Adenocarcinoma

Cardiotoxicity is a rare but serious complication of 5-fluorouracil therapy. Coronary vasospasm and, less frequently, acute myocarditis have been identified as underlying mechanisms. We report a case of severe toxicity in a relatively young and fit male patient being treated for metastatic colonic adenocarcinoma displaying characteristics that cannot be explained by either mechanism alone.

Topics: Adenocarcinoma; Antimetabolites, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Arrhythmias, Cardiac; Cardiomyopathy, Dilated; Cardiovascular Agents; Colonic Neoplasms; Coronary Vasospasm; Fluorouracil; Heart Diseases; Humans; Leucovorin; Liver Neoplasms; Male; Middle Aged; Myocarditis; Organoplatinum Compounds; Oxaliplatin; Treatment Outcome; Ventricular Dysfunction, Left

In a recent article published in The Lancet, investigators studied the impact of daily aspirin use on subsequent cancer deaths. Utilizing data from more than 25,000 patients enrolled in 8 large trials, which were originally intended to study the impact of daily aspirin use on the incidence of cardiovascular events, the authors found a substantial decrease in risk of fatal solid organ malignancies. In particular, the risk reduction was specific to adenocarcinomas. The findings from this study are highly relevant to the thoracic surgeon, with adenocarcinomas of the lung and esophagus among those tumors demonstrating the most profound risk reduction.

Topics: Adenocarcinoma; Adenocarcinoma of Lung; Anticarcinogenic Agents; Aspirin; Cardiovascular Agents; Cardiovascular Diseases; Esophageal Neoplasms; Humans; Incidence; Lung Neoplasms; Neoplasms; Preventive Health Services; Risk Assessment; Risk Factors

The authors report the case of a man with a laryngeal neoplasm treated by chemotherapy including 5 FU who presented a severe cardiogenic shock responding to medical therapy with a favourable outcome. This classical clinical presentation is commented by the authors. Based on the electrocardiogram, the echocardiography and a review of literature, they favour as first underlying hypothesis the secondary metabolic pathway linked to ribonucleic acid (RNA), rather than a possible coronary spasm.

Topics: Adenocarcinoma; Antineoplastic Combined Chemotherapy Protocols; Cardiovascular Agents; Fluorouracil; Humans; Laryngeal Neoplasms; Male; Middle Aged; Shock, Cardiogenic