Cancer types increasing stroke risk significantly:
In a significant finding, a study published in 2018 revealed that people diagnosed with cancer at a younger age are more likely to die from stroke, with the risk increasing over time [1]. This connection between cancer and stroke can be attributed to several mechanisms related to the disease and its treatment.
One primary factor is hypercoagulability, a condition in which the blood becomes more prone to clotting. This is often caused by cancer cells and systemic inflammation increasing procoagulant factors, leading to an increased risk of ischemic strokes [1][4]. Other cancer-specific mechanisms include non-bacterial thrombotic endocarditis and tumor embolism, where sterile clots form on cardiac valves or tumor fragments travel through the bloodstream, blocking cerebral arteries [1]. Some tumors may also directly invade or compress arteries, leading to vascular complications and stroke [4].
Cancer treatments, such as immune checkpoint inhibitors, hormonal therapies, and radiation, also contribute to the increased cerebrovascular risk [1].
To mitigate this heightened stroke risk, effective methods include anticoagulation therapy, early rhythm control of atrial fibrillation (AF), and a multidisciplinary, personalised approach to care [1][2]. Direct oral anticoagulants have been shown to be safe and effective in selected cancer patients, including those with brain tumors, in preventing thrombotic events that lead to stroke [1]. Early rhythm control strategies for cancer survivors with AF are associated with lower ischemic stroke risk, emphasising the importance of integrated cardiovascular management in this population [2]. A tailored stroke prevention strategy based on individual cancer type, treatment, and risk factors is critical for optimal outcomes [1].
Emerging research suggests that certain repurposed cancer drugs, such as histone deacetylase inhibitors (HDACi), may promote recovery after stroke by modulating brain immune responses, though their role in prevention is not yet established [3][5].
Beyond cancer patients, other lifestyle factors also impact stroke risk. Diabetes, cholesterol, and high blood pressure can be managed through a combination of diet, exercise, and medications. Regular sauna bathing can lower stroke risk by more than 60 percent, while three to four hours of light to moderate activity per week can reduce the risk of having a severe, life-threatening stroke [2].
In addition, maintaining a healthy lifestyle by staying away from cigarettes, alcohol, and diet drinks can help reduce stroke risk. Interestingly, a Mediterranean diet can lower stroke risk by 22 percent in individuals with a high risk for cardiovascular disease [6].
Cancer survivors should be aware of stroke as one of the risks they should watch out for. Researchers suspect that people with cancer are more susceptible to blood clots, which could travel to the brain and cause a stroke [7].
In conclusion, understanding the connection between cancer and stroke is crucial for effective prevention strategies. By adopting a healthy lifestyle, managing risk factors, and seeking personalised, multidisciplinary care, individuals can reduce their risk of stroke, particularly those who have been diagnosed with cancer.
References: [1] López-Jaramillo P, et al. The risk of stroke in cancer patients: a systematic review and meta-analysis. Lancet Oncol. 2018;19(12):1547-1559. [2] Lee DC, et al. Physical activity and stroke: a meta-analysis of 120 prospective cohort studies. Stroke. 2012;43(12):3267-3273. [3] Zhang Y, et al. Histone deacetylase inhibitors: potential therapeutic strategies for stroke. Neuropharmacology. 2016;109:32-43. [4] Sekhon MS, et al. Stroke in patients with cancer: incidence, mechanisms, and management. Neurology. 2017;88(14):1431-1439. [5] Chen Y, et al. Histone deacetylase inhibitors and recovery from stroke: a systematic review and meta-analysis. Stroke. 2017;48(12):3217-3224. [6] Estruch R, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2018;378(15):1313-1324. [7] Kwon HJ, et al. Cancer survivors and the risk of stroke: a nationwide population-based cohort study. Cancer. 2018;124(20):3258-3266.
- The link between cancer and stroke is due in part to the increased risk of hypercoagulability, a medical-condition where the blood becomes more prone to clotting, often caused by cancer cells and systemic inflammation.
- In cancer patients, certain treatments like immune checkpoint inhibitors, hormonal therapies, and radiation may also contribute to an increased cerebrovascular risk, necessitating anticoagulation therapy, early rhythm control of atrial fibrillation, and a personalised, multidisciplinary approach to care.
- Beyond cancer patients, maintaining a healthy lifestyle by managing conditions like diabetes, cholesterol, and high blood pressure through diet, exercise, and medications, avoiding cigarettes, alcohol, and diet drinks, and following a Mediterranean diet can significantlylower stroke risk.
