Chemotherapy that contains Adriamycin (doxorubicin) can cause cardiomyopathy, heart damage with potentially serious consequences. Although all breast cancer patients treated with this drug are potentially vulnerable, the risk of Adriamycin-induced cardiomyopathy is heightened under some circumstances. Certain foods have been found to protect against Adriamycin-induced cardiomyopathy in laboratory animals without interfering with Adriamycin's cytotoxic effects against breast cancer cells.

Cardiomyopathy is a potentially devastating side effect of Adriamycin

Adriamycin has the potential to cause cardiomyopathy, heart muscle damage that can result in heart failure. Symptoms of cardiomyopathy can become apparent during chemotherapy, shortly afterwards, or years later. The damage can resolve quickly or be so severe as to cause death. At the moment, there is no treatment that can reverse the damage. Rates of chemotherapy-induced cardiomyopathy have variously been estimated at 2% to 15%. Adriamycin is the best known breast cancer drug that induces cardiomyopathy, however epirubicin, 5-FU, cisplatin and Herceptin can also contribute to cardiomyopathy.

Risk of cardiomyopathy is heightened under some circumstances

The combination of Adriamycin plus Herceptin (used to treated HER2 overexpressing breast cancer (HER2+)) is associated with an elevated risk of cardiomyopathy compared to Adriamycin alone. One study reported that use of the NSAID naproxen (Aleve) worsened Adriamycin-induced cardiomyopathy in rats. BRCA1 or BRCA2 mutation carriers appear to be at heightened risk of anthracycline-induced cardiomyopathy.

Some foods can reduce Adriamycin toxicity without reducing treatment effects

Although women with pre-existing cardiovascular disease are more vulnerable to the effects of cardiomyopathy, all breast cancer patients treated with Adriamycin should consider themselves to be potentially vulnerable to this side effect. Generally speaking, it is not possible to identify which patients will experience permanent Adriamycin-induced heart damage. Evaluation of cardiac function before, during and after treatment with an Adriamycin-based regimen can help identify cardiomyopathy, but it is not preventative.

The foods below have been found to protect against Adriamycin-induced cardiomyopathy in laboratory animals without interfering with the anti-cancer effects of the treatment:

Blueberries
Broccoli
Celery
Cherries, especially sour or tart
Chives
Cranberries
Garlic
Grape juice, purple

Grapes, red
Kale
Parsley
Saffron
Tomatoes
Turmeric
Turnip greens
Walnuts

Latest research shows grape reduces Adriamycin-induced heart damage in rats

The study referenced at the beginning of this news article was designed to investigate whether pre-treatment with an extract made up of grape seed and grape skin could reduce the cardiotoxicity of Adriamycin in rats. Adriamycin-induced cardiotoxicity appears to be the result of increased oxidative stress. The authors hypothesized that pre-treatment with an extract of grape seed and grape skin, a commonly used antioxidant agent, might alleviate the cardiotoxicity. In the study, one group of rats was injected with grape seed/skin extract for eight days. A control group of rats did not receive this treatment. On the fourth day, all of the rats received a single dose of Adriamycin. After the eight-day treatment period ended, the rat hearts were evaluated using a variety of techniques. Adriamycin was found to markedly affect heart activity. On the other hand, the rats that received the grape seed/skin extract had reduced Adriamycin-induced disturbances of heart function.

Grapes and grape juice are preferable to resveratrol

Although resveratrol is the best know anti-cancer component of grape seed and grape skin, other grape polyphenols also have chemopreventive effects and appear to work in synergy with resveratrol. In addition, there is some evidence that concentrated resveratrol can promote breast cancer cell migration and invasion at some dosage levels. Also, note that grape seed oil (including virgin grape seed oil) is not a good source of grape polyphenols.

Please see our article on breast cancer diet during Adriamycin chemotherapy for more information on how to optimize treatment and reduce side effects.