Cancer Care Beyond Tumors: Protecting Your Mind and Heart

Modern cancer treatments save lives, but they can also trigger emotional struggles and heart problems. Learn how to identify depression early and reduce cardiovascular risks with expert-backed advice and lifestyle strategies.

Spotting the signs of depression

When you're going through something big — like going through cancer treatment — it's normal for your emotions to be all over the place. One day you might be furious, the next day you might feel extremely sad, in shock, or even completely numb. You might even experience all of those emotions — and more — in the same day, or even in the same hour. Everyone processes major life disruptors differently, and that's okay.

However, if you feel like your life is being overtaken by huge, overwhelming emotions, or like you'll never feel happy again, it may be time to seek help. As many as one in four people with cancer report feeling depressed. And if you've experienced depression in the past, you may be more at risk for going through it again.

But how do you know if you’re depressed? It’s not always obvious. Asking yourself these two questions provide a useful starting point.

Are you feeling down or hopeless much of the time?

Have you lost interest in things you once used to enjoy, like hobbies, or socializing with family and friends?

If the answer to either is yes, it’s time to talk with your primary care provider or a member of your cancer team.

Sometimes symptoms of depression are less related to mood, but impact other parts of your life. For example, do you:

• Often feel worthless or bad about yourself
• Sleep too much or too little.
• Have less desire to eat or eat too much.
• Withdraw from friends or family.
• Feel like you have no energy.
• Frequently lose your concentration.
• Sometimes think you might hurt yourself or that it would be better if you are dead

Any of these can happen with depression. But this last one, having thoughts about committing suicide or feeling that your life isn’t worth living, means you need to get help right away. Call your doctor, go to an emergency room.

That said, depression is treatable, so there's no need to suffer in silence. Talking to a professional about how you feel is the first step to finding a bit more joy in your daily life. 

When cancer treatment affects the heart

As improved therapies continue to extend lives, people with cancer may be more likely to die of something else, especially heart disease. “Modern cancer treatments often lead to long remissions from cancer,” says Dr. Ohad Oren, a cardiology fellow at Harvard-affiliated Massachusetts General Hospital. However, side effects from cancer therapies can affect the heart and blood vessels, possibly causing serious, sometimes life-threatening complications, he says. Broader recognition of these potential problems has increased referrals to cardio-oncology clinics, which focus on preventing and managing cardiovascular problems in people who are undergoing (or have completed) treatment for cancer.

Targeted cancer therapies

The risk of heart problems during or after cancer treatment depends on the type and amount of drugs or radiation you receive and how healthy your heart was before the treatment. Older chemotherapy drugs called anthracyclines are well known to damage the heart. But in recent years, it’s become clear that newer, targeted cancer therapies can also affect the cardiovascular system, says Dr. Oren. These drugs specifically target biological factors that underlie cancer. For example, some block signals that enable cancer cells to grow, while others trigger the immune system to destroy cancer cells.

It’s tempting to think that these newer drugs target only cancer cells and not normal, healthy cells. Unfortunately, that’s not the case, says Dr. Oren.

About 40% of people with cancer may be eligible for a promising class of drugs known as immune checkpoint inhibitors. These therapies are usually well tolerated, but up to 2% of people may develop heart muscle inflammation (myocarditis), says Dr. Oren. While some cases of myocarditis are mild, others can lead to heart rhythm abnormalities or heart failure. Currently, research on other possible heart-related effects from these immunotherapy drugs is a topic of intense investigation, Dr. Oren notes.

Advice for cancer patients

Ask your doctor whether your planned treatment might lead to cardiovascular problems, advises Dr. Oren. This is especially important for people ages 65 and older and anyone with risk factors for heart disease (such as high blood pressure or diabetes), who may want to request a referral to a cardio-oncologist. Potentially helpful heart-protecting strategies include statins, blood pressure drugs, and exercise.

In fact, some studies found that exercise during chemotherapy for cancer is not only safe and helps to improve fitness levels and heart function, but may also relieve some of the side effects of cancer treatment, such as fatigue. Be sure to start slowly and gradually increase your exercise over time with guidance from your oncologist, advises Dr. Oren.

Don’t ignore the signs—your mental and heart health matter. Reach out to your doctor for guidance on emotional support and cardio-oncology care. Together, you can build a healthier future beyond cancer.

This article is part of our collaboration with Harvard Health Publishing, a trusted source of medical expertise from Harvard Medical School. Content has been adapted for local audiences.

Copyright © 2025 by Harvard University. Original work prepared by Harvard Health Publishing. This content is for informational purposes only and does not replace professional medical advice, and do not represent the views of Manulife (Singapore) Pte. Ltd.